肝脏 ›› 2018, Vol. 23 ›› Issue (7): 580-582.

• 论 著 • 上一篇    下一篇

肝脏孤立性坏死结节的MRI表现

史芳芳, 胡海东, 郑增, 安维民   

  1. 100039 北京 解放军第三○二医院放射科
  • 收稿日期:2018-02-12 发布日期:2020-04-28
  • 通讯作者: 胡海东,Email:hhaidong7207@sina.com

MRI features of solitary necrotic nodule in liver

SHI Fang-fang, HU Hai-dong, ZHENG Zeng, AN Wei-min   

  1. Department of Radiology, 302 Hospital of PLA, Beijing 100039, China
  • Received:2018-02-12 Published:2020-04-28
  • Contact: HU Hai-dong, Email:hhaidong7207@sina.com

摘要: 目的 探讨肝脏孤立性坏死结节(SNN)的MRI平扫及动态增强扫描的特征及其鉴别诊断,以提高对SNN的诊断。方法 回顾性分析2012年至2017年经证实的34例患者SNN的资料,对病灶的MRI平扫和增强扫描后的信号及强化方式进行评价。结果 共发现34个病灶,肿瘤最大径0.7~4.9 cm,病变分布左叶7例,右叶24例,尾叶3例。平扫MRI示DWI上7个病变呈稍低信号,8个病灶呈等信号,19个病灶呈稍高信号;T1WI示25个病灶呈稍低信号,6个病灶呈等信号,3个病灶呈稍高信号;T2WI示19个呈稍高信号,9个呈等信号,5个病灶呈稍低信号。动态增强扫描28个病灶内部未见明确对比强化,门脉期及延迟期病变边缘见薄壁样强化,病变边界清晰,3个病灶各期均无强化呈低信号,另有3例病灶动脉期病变内见斑片状轻度强化,延迟期病变边缘强化,中央分隔样强化。结论 SNN的MRI动态增强扫描的特征性表现为增强扫描时边缘持续薄壁样强化,边缘清晰,这对SNN的诊断有一定提示价值。

关键词: 肝脏, 孤立性坏死结节, 磁共振成像

Abstract: Objective To investigate the features and differential diagnosis of liver solitary necrotic nodules (SNNs) in both plain and dynamic contrast-enhanced magnetic resonance imaging (MRI) scan in order to improve the diagnosis of SNN. Methods Thirty-four patients with biopsy confirmed SNN from 2012 to 2017 in our hospital were analyzed retrospectively. The lesions in both plain and enhanced MRI scan were evaluated. Results A total of 34 lesions were found, whose maximum diameter ranged from 0.7 to 4.9 cm. There were 7 lesions distributed in the left lobe, 24 in the right lobe and 3 in the tail lobe. In diffusion weighted imaging (DWI), 7 lesions showed hypointense signals, 8 showed isointense signals, and 19 showed hyperintense signals. On T1WI, 25 lesions showed slightly hypointense signals, 6 showed isointense signals, and 3 showed lightly hyperintense signals. On T2WI, 19 lesions showed slightly hypointense signals, 9 showed isointense signals, and 5 showed slightly hyperintense signals. The dynamic contrast-enhanced scan of 28 lesions showed no enhancement inside nodules but peripherally circular enhancement with clear edge in the portal phase and delayed phase. However, 3 lesions showed no enhancement in all phases. Besides, the other 3 lesions show mild patchy enhancement in arterial phase, and peripheral enhancement with separation-like enhancement in the delayed phase. Conclusion The characteristic features of SNNs in dynamic contrast-enhanced MRI scan are peripherally circular enhancement with clear edge, which is valuable in the diagnosis of SNN.

Key words: Liver, Solitary necrotic nodule, MRI