肝胆特异期成像在肝脏囊性转移瘤的诊断和鉴别诊断价值  

The Value of Hepatobiliary Specific Phase Imaging in the Diagnosis and Differential Diagnosis of Hepatic Cystic Metastases

作　　者：张文昌[1] 王世英 熊晓玲[1] 苏鸿林[1] 张彩宗 卢雪芬 Zhang Wenchang;Wang Shiying;Xiong Xiaoling;Su Honglin;Zhang Caizong;Lu Xuefen(CT/MRI Room,Imaaing Department,Second Hospitai of Longyan City,Fujian Province,Longyan,Fujian 364000)

机构地区：[1]福建省龙岩市第二医院影像科CT/MRI室,福建龙岩364000

出　　处：《现代医用影像学》2020年第8期1417-1421,共5页Modern Medical Imageology

摘　　要：目的:探讨肝细胞特异性对比剂(钆贝葡胺和钆塞酸二钠)肝胆特异期成像在肝脏囊性转移瘤的诊断和鉴别诊断价值。方法:回顾性分析10例(共18个病灶)经临床随访观察或综合治疗后证实的肝脏囊性转移瘤的MRI影像资料,所有患者均行平扫、肝细胞特异性对比剂增强及肝胆特异期扫描。结果:18个肝脏囊性转移瘤病灶中,单囊型6个(33.3%)、单囊伴附壁结节型11个(61.1%)、囊内分隔型1个(5.6%)。囊壁多表现厚薄欠均匀伴内壁毛糙,也可表现为囊壁菲薄且厚薄均匀,增强后囊壁、壁结节及囊内分隔可表现为不同程度强化,单纯囊肿型囊壁未见明确强化。肝胆特异期囊腔内对比剂潴留表现为特征性的中心圆点征(3/18)、牛眼征(13/18)、亮灯泡征(2/18)。结论:肝脏囊性转移瘤肝胆特异期具有特征性MRI表现,结合原发恶性肿瘤病史,可与肝囊肿、肝脓肿、肝囊腺瘤或囊腺癌、肝内胆管错构瘤等鉴别,对肝脏囊性病变具有重要诊断和鉴别诊断价值。Objective:To investigate the value of the application of hepatobiliary specific phase imaging injecting Gd-BOPTA or Gd-EOB-DTPA in the diagnosis and differential diagnosis of hepatic cystic metastases.Methods:Retrospective analysis was performed on 10 cases of hepatic cystic metastases confirmed by clinical follow-up observation or combined treatment, with a total of 18 lesions.Conventional plain scan,dynamic contrast-enhanced scan and hepatobiliary specific phase scan were performed to analyze the MRI features in all patients.Results:18 lesions of hepatic cystic metastases were divided into single cystic type(6/18,33.3%), single cystic with wall nodule type(11/18,61.1%), and intracystic ompartmentalized type(1/18,5.6%). The cystic wall showed less uniform thickness and rough inner wall, but also thin and uniform thickness of the cystic wall. After enhancement, the cystic wall, wall nodules and intracystic space could show different degrees of enhancement, but no clear enhancement was found in the single cystic wall. Hepatobiliary specific phase typically presents as central dot sign(3/18), bovine eye sign(13/18) or bright bulb sign(2/18).Conclusion:Hepatic cystic metastases in the hepatobiliary specific phase have characteristic MRI manifestations. Combined with the history of primary malignant tumor, it can be differentiated from hepatic cyst, hepatic abscess, hepatic cystadenoma or cystadenocarcinoma, and intrahepatic bile duct hamartoma, etc., which has important diagnostic and differential diagnostic value for hepatic cystic lesions.

关 键 词：肝胆特异期 肝脏 囊性 转移瘤 

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