摘要
目的探讨肝脏炎性肌纤维母细胞瘤(HIMT)CT、MRI特征与病理改变的关系,提高对其的诊断准确率。资料与方法经手术及病理证实的HIMT患者19例,其中男12例,女7例,年龄27～79岁,平均46.7岁。18例行CT平扫及增强扫描;1例仅行CT平扫,7例同时行CT、MRI平扫及增强扫描。结果 19例中15例为单发病灶,4例多发,共26个病灶,位于肝左叶4个,肝右叶22个。组织学分型包括黄色肉芽肿型15例:CT平扫低密度12例,等密度3例;14例增强扫描,动脉期1例明显强化,门静脉期轻度强化10例,平衡期轻度强化4例。4例行MRI检查,T1WI呈等信号1例,低信号3例,T2WI均为高信号。增强扫描4例动脉期均无强化,门静脉期或平衡期轻度强化。浆细胞肉芽肿型3例:CT平扫呈稍低密度2例,等密度1例。增强扫描动脉期均无强化,门静脉期或平衡期轻度强化;行MRI检查2例,增强扫描呈壁结节强化。硬化型1例:CT平扫为等、低混杂密度影,增强扫描动脉期无强化,门静脉期呈均匀强化,平衡期病灶密度减低。MRI平扫T1WI为等信号,T2WI为高信号,增强扫描动脉期无强化,门静脉期轻度强化,延迟期强化明显。26个病灶中4个有假包膜。结论 CT及MRI平扫及增强扫描能够反映HIMT组织学变化特点,但对不同类型病变的CT、MRI鉴别诊断仍比较困难。
Objective To investigate the CT and MRI characteristics of hepatic inflammatory myofibroblastic tumor（HIMT）and to improve the diagnosis.Materials and Methods The clinical data and CT,MRI images of 19 patients（12 men and 7 women,27-79 years old,mean age of 46.7 years） with pathologically proved HIMT were analyzed.Eighteen patients performed both the plain and enhanced CT scan;7 patients performed CT and MRI examination.The CT,MRI findings,including tumor location,size,shape,CT density or MRI signal of the different histological type of HIMT were retrospective analyzed.Results Fifteen patients had single lesions,4 patients had multiple lesions,and a total of 26 lesions were found.Among them,four lesions were in left lobe,22 lesions were in right lobe.Histopathological examination revealed fifteen patients were xanthogranulomatous.Plain CT scan showed hypodensity in 12 patients,isodensity in 3 patients.fourteen patients performed enhanced CT scan,1 patient had significant enhancement during arterial phase,10 patients had slight enhancement during portal venous phase,4 patients had slight enhancement during delayed phase.Among the type of xanthogranulomatous,4 patients underwent MRI examination.One lesion showed isointense signal on T1WI,3 lesions showed hypointense signal on T1WI,all the lesions were hyperintense signal on T2WI.Enhanced MRI showed no enhancement in 4 lesions during arterial phase,and slight enhancement during portal venous phase or the delayed phase.Histopathological examination revealed 3 patients were plasmacellgranulomatous： plain CT scan showed hypodensity in 2 patients,isodensity in 1 patient.Enhanced CT showed no enhancement during arterial phase,while slight enhancement during the portal phase or the delayed phase.Two patients underwent MRI examination.Enhanced MRI showed peripheral nodular enhancement.Histopathological examination revealed 1 patient was sclerotic：plain CT scan showed mixed density（isodensity and hypodensity）,no enhancement during arterial phase,homogeneous enhancement during portal phase,and hypodensity during delayed phase.The tumor was isointense signal on T1WI,and hyperintense o T2WI,no enhancement during arterial phase,slight enhancement during portal phase,and significant enhancement during delayed phase.Among the 26 lesions,4 lesions had pseudocapsule.Conclusion Both CT and MRI are able to reflect the different histopathological features of HIMT,whereas it is still difficult for differential diagnosis.
出处
《临床放射学杂志》
CSCD
北大核心
2011年第3期356-359,共4页
Journal of Clinical Radiology
关键词
肝脏
炎性肌纤维母细胞瘤
体层摄影术
X线计算机
磁共振成像
病理
Liver Hepatic inflammatory myofibroblastic tumor Tomography
X-ray computed Magnetic resonance imaging Pathological
