肝脏不同肿瘤性病变中央瘢痕的CT及MRI表现与研究价值  

Analysis of CT/MR signs of central scars in different liver tumors

作　　者：罗江[1] 徐勤[1] 杨琛 张静[1] LUO Jiang;XU Qin;YANG Chen;ZHANG Jing(Department of Radiology,Deyang Second People's Hospital,Deyang 618000,P.R.China)

机构地区：[1]四川省德阳市第二人民医院放射科

出　　处：《医学影像学杂志》2019年第12期2063-2067,共5页Journal of Medical Imaging

基　　金：四川省德阳市科学技术局科技支撑计划项目(编号:2016SZ011)

摘　　要：目的通过分析肝脏不同肿瘤性病变中央瘢痕的CT及MRI表现,探讨中央瘢痕对肝脏肿瘤性病变的诊断与鉴别诊断意义。方法回顾性分析我院近两年来经CT和(或)MRI检查的173例肝脏肿瘤,其中具有中央瘢痕者59例:肝血管瘤14例、局灶性结节增生(FNH)32例、纤维板层型肝癌(FLHCC)11例、肝细胞肝癌(HCC)和肝转移癌各1例。结果含中央瘢痕的血管瘤和FLHCC通常直径>5cm,FNH直径多数<5cm。FNH中央瘢痕较小、典型表现呈“星芒状”,平扫:CT表现为低密度、MRI呈长T 1长T 2信号,增强扫描延迟强化;FLHCC中央瘢痕大而宽、可达病灶边缘,平扫:CT表现为低密度、MRI各序列均呈低信号,增强扫描无强化或轻度延迟强化;巨大血管瘤中央瘢痕形态多样,平扫:CT表现为更低密度,MRI呈长T 1长T 2信号,增强扫描无强化;HCC中央瘢痕延迟扫描无强化;转移癌的中央瘢痕类似液化、坏死,增强后无明显强化。结论中央瘢痕的不同形态及特征性强化方式结合瘤体主体的强化特征对肝脏肿瘤的定性和鉴别具有非常重要的参考价值。Objective To analyze the CT and MRIfingdings of central scar in different hepatic lesiongs of the liver,and to explore the significance of central scar in the diagnosis and differential diagnosis of hepatic neopiastic lesions.Methods A retrospective analysis was conducted on 173 cases of liver tumors examined by CT and/or MRI in our hospital in recent two years,including 59 cases of central scar,14 cases of hepatic hemangioma,32 cases of focal nodular hyperplasia(FNH),11 cases of fibrous lamellar hepatocellular carcinoma(FLHCC),1 case of hepatocellular carcinoma(HCC)and 1 case of hepatic metastasis.Results The diameter of hemangioma and FLHCC with central scar was usually>5 cm,and in most of FNH,diameters were<5 cm.FNH central scar was small,the typical performance was"star-shaped".Plain scan CT showed low density,MRI was long T 1 and long T 2 signal,enhanced scan delay enhancement;FLHCC central scar was large and wide,up to the edge of the lesion,flat Sweep CT showed low-density,MRI sequences showed low signal,enhanced scan without enhancement or middle delay enhancement;large hemangionma central scar morphology,flat scan CT showed lower density,MRI showed long T 1 length T 2 signal,enhanced scan without enhancement;HCC central scar delayed scan without enhancement.Central scar of metastatic cancer was similar to liquefaction and necrosis,no significant enhancemen appeared after enhancemen.Conclusion The different forms and characteristic enhancement methods of central scar combined with the enhanced features of the main body of the tumor have important reference value for the identification and identification of liver tumors.

关 键 词：中央瘢痕 肝脏肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445[医药卫生—临床医学]