摘要
目的 分析与研究肝脏硬化性血管瘤的CT和磁共振成像(MRI)影像学特征及表现。方法 回顾性分析2020年1月至2023年12月我院经手术或穿刺及病理检查确诊为肝脏硬化性血管瘤患者的临床资料,共60例。60例患者术前均接受常规CT检查和增强检查,12例患者接受常规MRI检查和增强检查。对CT和MRI的影像学特征及表现进行分析,如病灶位置、形态、大小、常规检查的密度或信号特点与增强扫描后的强化特点,并与手术及病理检查结果进行对比。结果 60例患者病灶直径41~244 mm,多数患者超过50 mm;15例病灶外观表现为类圆形,其他45例表现为不规则性;39例病灶位置在肝边缘,位于右叶39例,左叶21例。通过CT常规检查可知,60例均为低密度的特征,其中12例均匀,48例病灶中存在不规则的更低密度区;进一步行增强扫描,在动脉期,48例病灶边缘存在强化(线状或结节样),在静脉期,强化表现为向心性或者蔓延至结节周围,内部存在低密度无强化区,在动脉期,12例无明显强化,在静脉期和延迟期,病灶边缘或内部存在轻度强化(分隔样),内部表现为无强化区,范围较大。12例患者MRI常规检查以低信号为主要表现,内部存在更低信号区;T2加权成像(T2WI)以轻、中度高信号为主要特征,内部伴有高信号区;扩散加权成像(DWI)以高信号为主要特征,均匀性差;对患者行增强检查,在动脉期,边缘存在强化,呈小结节状;静脉及延迟期扫描显示,伴有强化特征,呈向心性,不规则,中间部位存在无强化区。60例患者均经手术及病理检查确诊肝脏硬化性血管瘤,60例患者术前CT检出57例,检出率95%;12例患者术前MRI检出11例,检出率92%,CT和MRI与手术及病理检查结果的检出率差异无统计学意义(P>0.05)。结论 CT和MRI在肝脏硬化性血管瘤的诊断中具有重要价值,二者的影像学表现具有特征性,以病变中央部位的无强化区为主要表现。
Objective To analyze and study the CT and MRI imaging characteristics and manifestations of hepatic sclerosing hemangioma.Methods The clinical data of patients diagnosed with hepatic sclerosing hemangioma through surgery or puncture and pathological examination in our hospital from January 2020 to December 2023 was retrospectively analyzed.Sixty patients underwent routine CT and enhanced examinations before surgery,while 12 patients underwent routine MRI and enhanced examinations.Analyze the imaging features and manifestations of CT and MRI,such as lesion location,morphology,size,density or signal characteristics of routine examinations,and enhancement characteristics after contrast-enhanced scanning,and compare with the results of surgery and pathological examination.Results The diameter of lesions in 60 patients was 41~244 mm,and most patients exceeded 50 mm.Fifteen cases lesions appeared quasi-circular,while the other 45 cases showed irregularity.Thirty-nine cases had lesions located at the edge of the liver.Thirty-nine cases were located in the right lobe and 21 cases in the left lobe.Through routine CT examination,it was found that all 60 cases had low-density features,with 12 cases being uniform and 48 cases having irregular areas of lower density in the lesions.Further enhanced scanning was performed,and in the arterial phase,48 cases showed enhancement(linear or nodular)at the edge of the lesion.In the venous phase,the enhancement was oriented towards the heart or spread to the periphery of the nodule,with a low-density non-enhanced area inside.In the arterial phase,12 cases showed no significant enhancement.In the venous and delayed phases,there was mild enhancement(septate)at the edge or inside of the lesion,with a large range of non-enhanced areas inside.The routine MRI examination of 12 patients showed low signal as the main manifestation,with lower signal areas inside.T2WI is characterized by mild to moderate high signal intensity,with internal areas of high signal intensity.DWI is characterized by high signal intensity and poor uniformity.Enhanced examination was performed on the patient,and during the arterial phase,there was enhancement at the edges,appearing as small nodules.Venous and delayed phase scans showed enhanced features,with a cardiotropic and irregular pattern,and a non-enhanced area in the middle.All 60 patients were diagnosed with hepatic sclerosing hemangioma through surgery and pathological examination.Among the 60 patients,57 were detected by preoperative CT,with a detection rate of 95%.Among the 12 patients,11 were detected by preoperative MRI,with a detection rate of 92%.There was no significant difference in the detection rate between CT and MRI and surgical and pathological examination results(P>0.05).Conclusion CT and MRI have important value in the diagnosis of hepatic sclerosing hemangioma,and their imaging features are characteristic,with the non-enhanced area in the central part of the lesion as the main manifestation.
作者
侯鹏
鲍志国
Hou Peng;Bao Zhiguo(Department of Imaging,Qixian People's Hospital,Henan 475200,China;不详)
出处
《实用医学影像杂志》
2025年第6期446-450,共5页
Journal of Practical Medical Imaging
关键词
组织细胞瘤
良性纤维性
磁共振成像
影像学表现
Histiocytoma,benignfibroy
Magnetic resonance imaging
Imaging manifestations
