肝脏孤立性坏死结节的MRI和CT诊断及鉴别诊断  

MRI and CT appearances of solitary necrotic nodule of the liver

作　　者：邵丹丹[1] 王雪雪[1] 赵骞[2] 贾宁阳[1] 陈克敏[3] 程红岩[1] 

机构地区：[1]上海第二军医大学附属东方肝胆外科医院放射科,上海200438 [2]上海第二军医大学附属东方肝胆外科医院病理科,上海200438 [3]上海交通大学医学院附属瑞金医院,上海200025

出　　处：《放射学实践》2015年第8期845-848,共4页Radiologic Practice

基　　金：上海市卫生局青年科研项目(20134y120)

摘　　要：目的:探讨肝脏孤立性坏死结节(SNN)的MRI、CT表现及其鉴别诊断价值。方法:回顾性分析经手术病理证实的47例SNN的临床及影像学资料。38例行腹部MRI平扫及增强检查,7例行腹部CT平扫及增强检查,2例同时行MRI和CT检查。结果:病灶位于肝右叶39例(39/47,83.0%),肝左叶8例(8/47,17.0%);分布于肝实质边缘42例(42/47,89.4%),肝脏深部5例(5/47,10.6%);病灶最大径≤2.5cm者25例(25/47,53.2%)、>2.5cm者22例(22/47,46.8%);形态不规则29例(29/47,61.7%),呈圆形或椭圆形18例(18/47,38.3%)。MRI示所有病灶于T1WI上呈低信号-等信号,32例病灶T2WI上呈等信号-稍高信号、8例呈稍低信号。CT平扫示所有病灶内部呈稍低-低密度影,1例病灶边缘可见环形钙化。三期增强扫描显示所有病灶内部无强化,周边有薄环状延迟强化,其中18例病灶内间隔有轻度强化。结论:SNN的MRI、CT表现具有一定特征性,有助于该病的诊断。Objective：To explore the MR and CT appearances and imaging differential diagnosis of solitary necrotic nodule （SNN）of the liver.Methods：The clinical and imaging features of 47 patients （29 men and 18 women;age range,32-71 years;median age,49 years）with pathologically confirmed SNN were retrospectively reviewed.All the cases underwent plain and dynamic contrast-enhanced MRI and/or CT scan of the abdomen （38 cases with MRI scan,7 cases with CT scan, and 2 cases with both MRI and CT scan）.Results：Thirty-nine lesions （39/47,83.0%）were located in the right lobe of the liver,and 8 （8/47,17.0%）in the left lobe.Forty-two lesions （42/47,89.4%）were found in the sub-capsular region,mean-while 5 lesions （5/47,10.6%）were located within the deep hepatic parenchyma.The maximum diameter of 25 masses （25/47,53.2%）were less than or equal to 2.5cm,and 22 masses （22/47,46.8%）were larger than 2.5cm.Twenty-nine masses （29/47,61.7%）were irregular,meanwhile 18 cases （18/47,38.3%）were round or oval.SNN presented hypo-intense or iso-intense on T1 WI in all cases.Thirty-two lesions were hyper-intense or iso-intense on T2 WI,and 8 lesions were hypo-in-tense on T2 WI.On the plain CT,all cases showed slightly low to low density within the lesions,of which only one case showed the annular calcification.After contrast administration,the central part of the lesions showed no enhancement,and the peripheral part showed thin ring-like delayed enhancement in all cases.In addition,18 lesions showed slightly delayed enhancement of the septa within the lesions.Conclusion：The MRI and CT appearances of solitary necrotic nodules of the liver are characteristic and helpful in the diagnosis of the diseases.

关 键 词：肝脏 孤立性坏死结节 磁共振成像 体层摄影术 X线计算机 病理学 

分 类 号：R575[医药卫生—消化系统] R816.5[医药卫生—内科学] R445.2[医药卫生—临床医学]