肝脏孤立性坏死结节的临床及影像学特征分析  

Clinical and imaging features of solitary necrotic nodule of the liver

作　　者：李丹燕[1] 麦筱莉[1] 田传帅[1] 朱斌[1] 张冰[1] 尹娜[2] LI Danyan;MAI Xiaoli;TIAN Chuanshuai;ZHU Bin;ZHANG Bing;YIN Na(Department of Radiology,the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China;CT Room,Jiangsu Cancer Hospital,Nanj ing 210009,China)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008 [2]江苏省肿瘤医院CT室,江苏南京210009

出　　处：《实用放射学杂志》2021年第11期1822-1825,共4页Journal of Practical Radiology

基　　金：江苏省干部保健科研课题(BJ19032)。

摘　　要：目的分析肝脏孤立性坏死结节(SNNL)临床及影像学特征。方法回顾性分析经病理证实的14例SNNL临床及影像资料。影像学特征包括病灶大小、位置、形态、密度、信号及增强特征等。结果SNNL好发于中年人群,无明显性别差异,大多数患者(85.8%)无明显临床症状。所有患者均为单发病灶,85.8%位于肝右叶,70%位于肝脏包膜下。80%患者CT平扫表现为等低密度,内可见斑片状软组织密度和点状钙化;MRI呈不均匀稍长T1稍长T2信号,60%T2WI中心可见点片状高信号即“靶征”,扩散加权成像(DWI)均表现为高信号。增强扫描50%可见包膜样强化,90%动脉期见轻到中度环形或斑片状强化合并中心小片状无强化区,静脉期强化轻度减退,延迟期70%可见延迟强化。结论SNNL无明显临床特征,当肝右叶包膜下出现类圆形病灶,内见斑片状实质成分,增强后动脉期实质成分及包膜强化,延迟期可见强化,T2WI出现“靶征”,DWI高信号时,应考虑SNNL可能。Objective To analyze the clinical and imaging features of solitary necrotic nodule of the liver(SNNL).Methods The clinical manifestation and imaging data of 14 SNNL patients confirmed by pathology were analyzed retrospectively.The imaging features including size,location,shape,density,signal intensity,and enhancement pattern of the lesions were recorded.Results Most of the patients were middle-aged and asymptomatic(85.8%),and no gender difference was observed.All nodules were solitary,85.8%of whom were located in the right lobe,and 70%of whom were subcapsular lesions.Plain CT showed the lesions were hypo-or isodense(80%)with inner patchy soft tissue and punctate calcification.Meanwhile,MRI showed the lesions were heterogeneously slight hypointensity on T1 WI and slight hyperintensity on T2 WI,and hyperintensity on diffusion weighted imaging(DWI).The central spotted patchy hyperintensity which was also known as“target sign”was observed in 60%cases on T2 WI.After contras-t enhancement,50%lesions appeared capsular enhancement and 90%appeared mild to moderate ring-like enhancement or patchy-like enhancement without inner enhancement in arterial phase.Moreover,the ring-like enhancement was slightly decreased in venous phase and persistent in the delayed phase(70%).Conclusion No specific clinical characters are observed in SNNL patients.However,the disease should be considered when a round-shaped subcapsular lesion is located in the right liver lobe with patchy soft tissue,rim or patchy-like enhancement in arterial phase,slightly persistent enhancement in the delayed phase,“target sign”on T2 WI and hyperintensity on DWI.

关 键 词：肝脏 孤立性坏死结节 磁共振成像 计算机体层成像 

分 类 号：R575[医药卫生—消化系统] R445.2[医药卫生—内科学]