肝脏孤立性坏死结节的MRI表现  

MRI features of solitary necrotic nodule in liver

作　　者：史芳芳 胡海东 郑增 安维民 SHI Fang-fang;HU Hai-dong;ZHENG Zeng;AN Wei-min(Department of Radiology,302 Hospital of PLA,Beijing 100039,China)

机构地区：[1]解放军第三○二医院放射科,北京100039

出　　处：《肝脏》2018年第7期580-582,共3页Chinese Hepatology

摘　　要：目的探讨肝脏孤立性坏死结节(SNN)的MRI平扫及动态增强扫描的特征及其鉴别诊断,以提高对SNN的诊断。方法回顾性分析2012年至2017年经证实的34例患者SNN的资料,对病灶的MRI平扫和增强扫描后的信号及强化方式进行评价。结果共发现34个病灶,肿瘤最大径0.7~4.9 cm,病变分布左叶7例,右叶24例,尾叶3例。平扫MRI示DWI上7个病变呈稍低信号,8个病灶呈等信号,19个病灶呈稍高信号;T1 WI示25个病灶呈稍低信号,6个病灶呈等信号,3个病灶呈稍高信号;T2 WI示19个呈稍高信号,9个呈等信号,5个病灶呈稍低信号。动态增强扫描28个病灶内部未见明确对比强化,门脉期及延迟期病变边缘见薄壁样强化,病变边界清晰,3个病灶各期均无强化呈低信号,另有3例病灶动脉期病变内见斑片状轻度强化,延迟期病变边缘强化,中央分隔样强化。结论 SNN的MRI动态增强扫描的特征性表现为增强扫描时边缘持续薄壁样强化,边缘清晰,这对SNN的诊断有一定提示价值。Objective To investigate the features and differential diagnosis of liver solitary necrotic nodules（SNNs）in both plain and dynamic contrast-enhanced magnetic resonance imaging（MRI）scan in order to improve the diagnosis of SNN.Methods Thirty-four patients with biopsy confirmed SNN from 2012 to 2017 in our hospital were analyzed retrospectively.The lesions in both plain and enhanced MRI scan were evaluated.Results A total of 34 lesions were found,whose maximum diameter ranged from0.7 to 4.9 cm.There were 7 lesions distributed in the left lobe,24 in the right lobe and 3 in the tail lobe.In diffusion weighted imaging（DWI）,7 lesions showed hypointense signals,8 showed isointense signals,and 19 showed hyperintense signals.On T1 WI,25 lesions showed slightly hypointense signals,6 showed isointense signals,and 3 showed lightly hyperintense signals.On T2 WI,19 lesions showed slightly hypointense signals,9 showed isointense signals,and 5 showed slightly hyperintense signals.The dynamic contrast-enhanced scan of 28 lesions showed no enhancement inside nodules but peripherally circular enhancement with clear edge in the portal phase and delayed phase.However,3 lesions showed no enhancement in all phases.Besides,the other 3 lesions show mild patchy enhancement in arterial phase,and peripheral enhancement with separation-like enhancement in the delayed phase.Conclusion The characteristic features of SNNs in dynamic contrast-enhanced MRI scan are peripherally circular enhancement with clear edge,which is valuable in the diagnosis of SNN.

关 键 词：肝脏 孤立性坏死结节 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]