肝假性淋巴瘤的MRI征象分析  

Magnetic resonance imaging features of hepatic pseudolymphoma

作　　者：方艺 施新 周国锋 徐进 郑信德 FANG Yi;SHI Xin;ZHOU Guo-feng;XU Jin;ZHEN Xin-de(Department of Imaging,Yancheng NO.1 People’s Hospital,Yancheng 224000,Jiangsu,China;Department of Imaging,Chongming Branch of Shanghai 10th People’s Hospital,Shanghai 202157,China;Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]盐城市第一人民医院影像科,盐城224000 [2]上海市第十人民医院崇明分院影像科,上海202157 [3]复旦大学附属中山医院放射科,上海200032

出　　处：《中国临床医学》2022年第4期659-663,共5页Chinese Journal of Clinical Medicine

摘　　要：目的探讨肝假性淋巴瘤扩散加权成像(diffusion-weighted imaging,DWI)和动态增强磁共振成像(dynamic contrast-enhancement magnetic resonance imaging,DCE-MRI)的特征。方法回顾性分析2014年2月至2021年2月在复旦大学附属中山医院经病理证实的14例肝假性淋巴瘤患者22个病灶的MRI表现,定性评价各序列信号特征及DCE-MRI各期强化特征。结果病灶在MRI平扫上呈同质性,DWI明显高信号,表观扩散系数(apparent diffusion coefficient,ADC)明显低信号。DWI上,15个病灶周围呈现沿汇管区线性高信号;3个病灶在T2WI和DWI上呈现从病变处沿门静脉延伸的邻近肝实质楔形水肿信号改变。动态增强后,7个病灶动脉期厚壁环形强化,门脉期及延迟期病变内部强化幅度减低,周围持续环形强化;13个病灶动脉期不同程度强化,其中9个病灶轻中度强化、4个病灶明显强化,门脉期及延迟期中央廓清,边缘仍强化;2个病灶动脉期轻中度强化,门脉期及延迟期呈等信号。结论肝假性淋巴瘤在MRI上多信号均匀、扩散明显受限,DCE-MRI不同时期环形强化,DWI上病灶周围汇管区线性高信号或沿门静脉邻近肝实质楔形水肿有助于诊断。Objective To explore the features of hepatic pseudolymphoma on diffusion weighted imaging(DWI)and dynamic contrast-enhancement magnetic resonance imaging(DCE-MRI).Methods The MRI findings of 22 lesions in 14 patients with hepatic pseudolymphoma confirmed by pathology in Zhongshan Hospital,Fudan University from February 2014 to February 2021 were retrospectively analyzed.The characteristics of MRI sequence signals and the characteristics of dynamic enhancement at each stage were qualitatively evaluated.Results On MRI plain scan,the lesions were homogeneous,with obviously high signal on DWI and obviously low signal on apparent diffusion coefficient(ADC).The tissue around 15 lesions showed linear high signal along the portal area on DWI.Wedge-shaped signal changes in adjacent liver parenchyma extending from the lesion along portal vein were also observed on T2WI and DWI in 3 lesions.After enhancement,7 lesions had thick wall circular enhancement in arterial phase,the enhancement amplitude in portal vein and delayed phase was reduced,and the peripheral circular enhancement continued.13 lesions were enhanced to varying degrees in the arterial phase,including 9 lesions with mild to moderate enhancement and 4 lesions with obvious enhancement,the central clearance in the portal phase and delayed phase,and the edge was still enhanced.Two lesions showed mild to moderate enhancement in arterial phase,and isointense in portal and delayed phases.Conclusions Homogeneous signal,obvious restricted signal distribution and circular enhancement at different stages of DCE-MRI are specific signs of hepatic pseudolymphoma.Linear high DWI signal in the portal area around the lesion and wedge-shaped edema along the portal vein adjacent to the liver parenchyma are more helpful for the diagnosis of hepatic pseudolymphoma.

关 键 词：肝假性淋巴瘤 反应性淋巴样组织增生 扩散加权成像 动态增强磁共振 

分 类 号：R735.7[医药卫生—肿瘤]