摘要
目的探讨磁共振成像(MRI)长时间延迟增强扫描诊断肝脏孤立性坏死性结节(SNNL)的价值。方法2013年5月~2018年5月我院就诊的17例SNNL患者和15例肝脏恶性肿瘤患者(其中10例为肝细胞癌和5例为肝转移癌),所有患者均行常规CT/MRI增强扫描及MRI多期长时间延迟至120 min扫描,分别比较两组病灶影像学特征,如病灶密度、强化类型,探讨长时间延迟扫描在鉴别SNNL与肝脏恶性肿瘤中的作用。结果在SNNL患者,CT和MRI共检出17个病灶,均位于肝右叶,且均为单发病灶,直径为(2.1±0.4)cm;在10例HCC患者,MRI检查发现11个病灶,位于肝右叶者8个,位于肝左叶者3个。单发病灶9例,多发病灶1例,直径为(5.4±1.6)cm;在5例肝脏转移癌患者中,共检出12个病灶,位于肝右叶者9个,位于肝左叶者3个,直径为(3.1±0.9)cm;在SNNL病灶中有4个病灶在T2WI上表现为“靶征”,与肝转移癌病灶的影像学表现类似;在延迟期(DP)3/5 min扫描,HCC和肝转移癌病灶边缘多呈中度-重度环形强化,SNNL病灶边缘强化水平随着延迟时间延长而逐渐增强。在DP 1 h时,17个病灶均表现为中度-重度环形强化,病灶中心无强化,而肝脏恶性肿瘤病变边缘强化均已消失。结论MRI长时间延迟增强扫描能有效区分SNNL与肝脏恶性肿瘤,主要表现为在延迟扫描时呈病灶边缘和间隔环形强化,且病变中心无强化。
Objective To evaluate the value of long-time delayed contrast-enhanced scan of magnetic resonance imaging(MRI)in the diagnosis of patients with solitary necrotic nodules of the liver(SNNL).Methods 17 patients with SNNL and 15 patients with malignant liver tumors(including 10 with hepatocellular carcinomas and 5 with hepatic metastases)were admitted to our hospital between May 2013 and May 2018,and all patients underwent conventional CT/MRI enhanced scan and multi-phase long-delayed to 120 minute MRI scanning.The imaging characteristics,such as density and enhancement type of the lesions were compared between the two groups.Result Out of 17 patients with SNNL,17 single foci were found by CT and MRI scan,all localized in right lobe with the diameters of(2.1±0.4)cm;out of 10 patients with HCC,MRI scan demonstrated 11 foci,8 localized in right and 3 in left lobe with the diameters of(5.4±1.6)cm;out of 5 patients with metastases,12 foci were found,9 localized in right,and 3 in left lobe,with the diameters of(3.1±0.9)cm;four SNNL lesions showed“target sign”on T2WI and the imaging manifestation of liver metastases were similar to those of SNNL;at delayed phase(DP)3/5 min,the edge of HCC and liver metastasis foci showed moderate to severe circular enhancement,and the enhancement in SNNL was intensified as the scan time prolonged;at DP 1 hour,17 SNNL foci showed moderate to severe circular enhancement and no enhancement in the centre of each lesion,while all enhancement in tumors disappeared.Conclusions Long-time delayed contrast-enhanced MRI might effectively distinguish SNNL from malignant hepatic tumors,which needs further investigation.
作者
曾艳妮
张灿
毕俊英
刘良进
孟俊
秦涛
Zeng Yanni;Zhang Can;Bi Junying(Department of Radiology,Third People's Hospital,Wuhan 430033,Hubei Province)
出处
《实用肝脏病杂志》
CAS
2019年第6期900-903,共4页
Journal of Practical Hepatology
基金
湖北省自然科学基金资助项目(编号:3689272)
