肝脏炎性假瘤“厚壁圆环中心点”征CT与MR表现  

“Thick-torus-wall & Central-dot”Sign: CT and MR Feature of Inflammatory Pseudotumor of Liver

作　　者：张见增[1] 胡海东[1] 王巍巍 董景辉[1] 安维民[1] 

机构地区：[1]解放军302医院放射科,北京100039

出　　处：《临床放射学杂志》2017年第9期1368-1372,共5页Journal of Clinical Radiology

摘　　要：目的探讨肝脏炎性假瘤(IPTL)"厚壁圆环中心点"征的CT与MR表现特点。方法搜集经病理诊断(8例)及临床诊断(9例)的IPTL共17例常规肝脏CT及/或MR平扫及动态增强资料,综合分析病灶的形态及密度/信号表现。结果 (1)全部病例病变影像形态学均可分为两部分,即"厚壁圆环"和"中心点"。"厚壁圆环"表现:厚壁结构占病灶大部;部分/全部呈较明显类圆形,内外缘较清晰;呈多层不同厚度、欠规则同心环状,但整体厚度较均匀一致;呈渐进性强化。"中心点"表现:中心区仅占小部分或呈近似点状;每个病灶内可为一点或多点;各期无强化。(2)17例患者中单发11例,双发或多发6例、其中2例弥漫多发。(3)单发或散在多发"厚壁圆环中心点"14例,多个该结构融合(7例,其中部分病例为多发病灶中的部分融合)。(4)病变各部无固定CT密度值或MR信号特征。(5)病理证实的8例占同期纳入研究的IPTL病例的21.6%(8/37)。结论 "厚壁圆环中心点"征是部分IPTL的一个较特异影像征象,能否作为IPTL的一种独立影像分型有待进一步研究。Objective To discuss the CT and MR characteristic features of inflammatory pseudotumor of liver（ IPTL） ：＂Thick-torus-wall Central-dot＂sign. Methods 17 cases of IPTL proved by pathology（ 8 cases） and/or clinical reexamination（ 9 cases） were gathered. The image findings were analyzed after routine CT/MRI plain scan and dynamic enhancement. Results（ 1） Every lesion in all cases may be divided into two parts of ＂Thick-torus-wall＂and ＂Centraldot＂,respectively. The performance of ＂Thick-torus-wall＂include these features： This structure is one greater part of lesion; Part or entire wall is rather round,and its internal and external border are both clear; The wall displays a concentric annulus formed with different layer thickness and every layer may be irregular but the thickness of whole wall is nearly uniform; The wallexhibits gradual enhancement. The performance of ＂Central-dot＂include these： This area is a rather small part of lesion even like a dot; one dot or more dots in every lesion; no contrast enhancement in all scan phases.（ 2） In 17 cases,11 cases＇ lesion is solitary; 6 cases＇ lesions are multiple,and with 2 cases＇ lesions being all over the liver.（ 3）The lesions may be solitary（ 14 cases,single or multiple scattered） or fusion of the structures above（ 7 cases,including some lesions of multiple）.（ 4） Every part of these two structures have no defined features of CT value or MR signal.（ 5）The ratio of cases with this typical imaging sign in all investigative cases which have pathological diagnosis of IPTL in same period is 21. 6%（ 8/37）. Conclusion ＂Thick-torus-wall Central-dot＂is a distinctive imaging sign of a part of IPTL,and whether or not they can be regarded as an independent imaging classification in all IPTL needs further study.

关 键 词：肝疾病 炎性假瘤 炎性肌纤维母细胞瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R735.7[医药卫生—临床医学]