MRI诊断不典型肝脓肿临床应用价值分析  

MRI and DWI feature in patients with atypical hepatic abscess

作　　者：马紫瑶 王超 赵珏 冯赟 张铭 梁凯轶 Ma Ziyao;Wang Chao;Zhao Jue(Department of Radiology,District Central Hospital Affiliated to Shanghai University of Health Sciences,Jiading 201800,Shanghai,China)

机构地区：[1]上海健康医学院附属嘉定区中心医院放射科,上海市201800 [2]上海市嘉定区南翔医院放射科 [3]上海交通大学医学院附属第一人民医院放射科

出　　处：《实用肝脏病杂志》2024年第6期931-934,共4页Journal of Practical Hepatology

基　　金：上海市卫健委科研计划项目(编号:201940315);上海市卫健委智慧影像重点实验室和上海市嘉定区医学重点专科建设项目(编号:2020-jdyxzdzk-02)。

摘　　要：目的探讨常规MRI联合扩散加权成像(DWI)对不典型肝脓肿(AHA)的诊断价值。方法2019年1月~2024年1月上海市嘉定区中心医院和上海市嘉定区南翔医院收治的42例AHA病灶和42例肝内转移瘤(IMT)患者,均接受MRI平扫、增强扫描和DWI检查。比较两组病灶MRI平扫和DWI信号、增强扫描信号、强化特征及病灶边缘实性部分表观扩散系数(ADC)和相对ADC(rADC)差异。结果AHA病灶DWI靶样高信号占比为64.3%,显著低于IMT病灶的90.5%(P<0.05);AHA病灶MRI增强扫描动脉期边缘强化、门静脉期和平衡期不均匀强化占比分别为45.2%、71.4%和23.8%%,均显著低于IMT病灶的76.2%、100.0%和88.1%(P<0.05);AHA病灶MRI增强扫描动脉期显著强化和连续性中断占比分别为9.5%和0.0%,均显著低于IMT病灶的88.1%和73.8%(P<0.05);AHA病灶边缘实性部分ADC和rADC分别为(1.8±0.4)×10^(-3)mm^(2)/s和(0.7±0.2)×10^(-3)mm^(2)/s,均显著高于IMT病灶【分别为(1.0±0.2)×10^(-3)mm^(2)/s和(0.4±0.1)×10^(-3)mm^(2)/s,P<0.05】。结论常规MRI联合DWI检查AHA病灶具有显著的信号特征,可帮助临床与肝内转移癌进行辨别。Objective The aim of this study was to explore imaging feature of atypical hepatic abscess(AHA)for early diagnosis.Methods 42 patients with AHA and 42 patients with intrahepatic metastatic tumor(IMT)were encountered in our hospital between January 2019 and January 2024,and all underwent MRI and diffusion-weighted imaging(DWI)scan.Plain and enhanced scan signals,DWI signals,enhancement features at arterial phase,apparent diffusion coefficient(ADC)and relative ADC(rADC)of solid part in lesion margin were compared between the two groups.Results Proportion of target-like high signals by DWI in AHA lesions was significantly lower than that in IMT lesions(64.3%vs.90.5%(P<0.05);proportions of margin enhancement at arterial phase and uneven enhancement at portal vein phase and at equilibrium phase in AHA lesions were 45.2%,71.4%and 23.8%,significantly lower than 76.2%,100.0%and 88.1%(P<0.05)in the IMT lesions;proportions of significant enhancement and continuity interruption at arterial phase were 9.5%and 0.0%,significantly lower than 88.1%and 73.8%(P<0.05)in IMT lesions;ADC and rADC of solid parts at AHA lesion margin were(1.8±0.4)×10^(-3)mm^(2)/s and(0.7±0.2)×10^(-3)mm^(2)/s,both significantly higher than[(1.0±0.2)×10^(-3)mm^(2)/s and(0.4±0.1)×10^(-3)mm^(2)/s,P<0.05]at IMT lesions.Conclusion AHA lesions at routine MRI and DWI scan has a unique feature,by which clinicians might differentiate it from IMT lesions.

关 键 词：不典型肝脓肿 肝内转移瘤 常规MRI 扩散加权成像 表观扩散系数 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.4[医药卫生—诊断学]