自身免疫性肝炎的CT表现与临床特点  

CT features and clinical characteristics of autoimmune hepatitis

作　　者：宋燕[1] 史云菊[2] 徐红卫[1] 程敬亮[3] 谭延召[1] 

机构地区：[1]郑州大学第五附属医院放射科,河南郑州450052 [2]郑州铁路职业技术学院护理学院 [3]郑州大学第一附属医院磁共振科

出　　处：《实用放射学杂志》2013年第8期1274-1277,共4页Journal of Practical Radiology

摘　　要：目的探讨自身免疫性肝炎（AIH）的CT征象与临床特点，提高对该病的认识水平和诊断的准确性。方法收集临床确诊并经CT平扫和增强榆查的AIH患者16例，回顾性分析其临床表现、实验室检查结果及CT表现，总结AIH的诊断要点。结果16例AIH中，肝脏体积增大9例，缩小2例。肝实质密度均匀或不均匀减低14例；肝实质强化不均5例，表现为局灶性或地同样较明显强化或弱强化区。肝内门静脉周缘出现“晕环征”11例。胆囊壁水肿增厚12例。12例CT上可见淋巴结肿大，其中腹腔淋巴结肿大7例；腹膜后淋巴结肿大3例；腹膜腔和腹膜后淋巴结同时肿大2例。增强扫描见肿大淋巴结呈轻度均匀强化。8例肿夫淋巴结心同伴絮片状或带状低密度影。脾脏增大10例。胸、腹腔积液7例。结论AIH在CT上有一定表现，但缺乏特异性．AIH的诊断需结合临床、实验室检查，必要时肝穿活检。Objective To study the CT features and clinical characteristics of autoimmune hepatitis （AIHJ,and to improve the rccognization standard and diagnostic accuracy on AIH. Methods CT findings including plain and enhanced scan, clinical manifestations and laboratory examination of 16 patients with AIH confirmed by clinic were analysed retrospectively in order to summarize the diagnostic point of AIH. Results Among the 16 cases, liver volume increased in 9 cases and decreased in 2 cases. Liver parenchyma density decreased in 14 cases and uneven enhanced in 5 cases which showed focal or map-like higher or lower density. 11 cases were found halo sign around the portal vein of liver. Gallbladder wall in 12 cases showed edema and thickening. Lymph node enlargement appearcd in 12 cases, among which,7 cases were located in enterocoelia, 3 cases in retroperitoneal and 2 cases in both of them. The enlarged lymph nodes were mild and uniform enhanced. 8 cases were found low density of flake shape around the enlarged lymph nodes. Spleen volume increased in 10 cases. Hydrothorax and seroperitoneum were found in 7 cases. Conclusion CT findings of AIH has certain characteristics but without specificity, so it is necessary to combine with clinical manifestations, laboratory examination and even liver biopsy to diagnose AIH.

关 键 词：肝炎 自身免疫性 计算机体层成像 

分 类 号：R575.1[医药卫生—消化系统] R914.42[医药卫生—内科学]