摘要
目的：认识肝脓肿ＭＲＩ典型及不典型征象，探讨ＭＲＩ分型的诊断意义。材料和方法：６７例８２个肝脓肿经手术病理和临床治疗证实，回顾性分析平扫和增强ＭＲＩ表现，并进行归类分型。结果：８２个肝脓肿可分成三种ＭＲＩ类型：房腔型占７１．９５％（５９／８２），特征是病灶体积的２０％以上由液化坏死的房腔和纤维肉芽的腔壁构成；肉芽型占２０． ７３％（１７／８２），特征是病灶体积的８０％以上由纤维肉芽组织构成，间以细小液化或凝固坏死区；团块型占７．３２％（６／８２），特征是病灶酷似实质性肿瘤，多数伴有完整包膜。肉芽型及团块型是肝脓肿不典型表现，单纯平扫ＭＲＩ诊断的正确率为５６．５％（１３／２３），而平扫联合增强ＭＲＩ使正确率提高至８６．７％（２０／２３）。结论：ＭＲＩ分型有助于全面认识肝脓肿的病理演变及相应的影像表现，应用Ｇｄ－ＤＴＰＡ动态增强ＭＲＩ能提高各种类型肝脓肿的诊断正确率。
Purpose: To recognize typical and atypical MRI findings of liver abscesses and to evaluate the diagnostic significance of MRI classification. Materials and Methods: 82 liver abscesses in 67 patients were proved by pathology or posttherapy follow - up, and their MR findings before and after Gd - DTPA administration were retrospectively analyzed and classified. Results: Liver abscesses were divided into three types of MR features. The cavity type accounted for 71. 95 % (59/82), which characterized by a cavity of liquid necrosis and a wall of granulomatous fibrosis. The cavity occupied more than 20% area of lesion. The granuloma type ac- counted for 20. 73% (17/ 82) , which consisted of granulomatous and fibrous tissue over 80% of lesion and interspersed with small area of liquid and coagulative necrosis. The mass type accounted for 7. 32 % (6/82) , which was much similar to the neoplasm and had a complete capsule in most of lesions. The granuloma and mass type were atypical findings of liver abscesses and the diagnostic accuracy of both was 56. 5% (10/23) by only using plain MR imaging, but the accuracy could be improved to 86. 7% (20/ 23) by combining with enhanced MR imaging. Conclusions: MRI classification of liver abscesses is helpful to completely understand its pathologic changes and correlating image findings. The application of dynamic Gd - DTPA MR imaging can improve the diagnostic accuracy for all types of liver abscesses.
出处
《中国医学计算机成像杂志》
CSCD
2000年第3期188-191,共4页
Chinese Computed Medical Imaging
