肝脏融合性纤维化临床与影像分析

肝脏 ›› 2025, Vol. 30 ›› Issue (5): 592-594.

肝脏融合性纤维化临床与影像分析

刘阳, 刘静, 李志艳, 任洪伟, 张萌萌, 刘树红, 刘长春, 高珅, 刘渊

100070 北京首都医科大学附属北京天坛医院健康管理中心(刘阳);100039 北京解放军总医院第五医学中心超声科(刘静);518112 深圳深圳市第三人民医院超声科(李志艳);100039 北京解放军总医院第五医学中心放射诊断科(任洪伟,张萌萌,刘长春,高珅,刘渊);100039 北京解放军总医院第五医学中心病理科(刘树红)

收稿日期:2024-09-13 出版日期:2025-05-31 发布日期:2025-07-04
通讯作者: 刘渊,E-mail:liuyuan282_ok@163.com
基金资助:
首都卫生发展科研专项项目(首发2022-4-5061、首发2024-2-5066);解放军总医院新技术新业务项目(2023XJS-03)

The clinical and imaging analysis of confluent hepatic fibrosis

LIU Yang¹, LIU Jing², LI Zhi-yan³, REN Hong-wei⁴, ZHANG Meng-meng⁴, LIU Shu-hong⁵, LIU Chang-chun⁴, GAO Shen⁴, LIU Yuan⁴

1. Health Management Center,Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing 100070, China;
2. Department of Ultrasound, Fifth Medical Center of PLA General Hospital, Beijing 100039, China;
3. Department of Ultrasound, Shenzhen third people’s hospital, Shenzhen 518112, China;
4. Department of Radiology, Fifth Medical Center of PLA General Hospital, Beijing 100039, China;
5. Department of Pathology, Fifth Medical Center of PLA General Hospital, Beijing 100039, China

Received:2024-09-13 Online:2025-05-31 Published:2025-07-04
Contact: LIU Yuan, E-mail:liuyuan282_ok@163.com

摘要/Abstract

摘要： 目的探讨分析肝脏融合性纤维化(confluent fibrosis,CF)的临床和影像特征,以增加诊断经验和对该病的认识。方法回顾性分析2023年10月—2024年10月在解放军总医院第五医学中心住院治疗的19例经影像及穿刺病理证实的肝脏融合性纤维化患者的各项临床及影像资料,整理归纳患者的一般资料、病因类型及影像特征等。结果 19例CF患者临床症状以肝功能异常、乏力、腹胀腹痛为主,病理穿刺结果8例为药物性肝损害,6例为自身免疫性肝病。MR腹部增强扫描图像显示18例患者肝内病灶为单发,15例病灶位于肝右叶,6例患者可见肝脏体积缩小及肝包膜皱缩,强化模式为渐进性强化,动脉期多无明显强化,门脉期及延迟期呈较高信号。结论 CF在中老年女性中较为多见,多无特异性临床症状,主要致病因素以药物性或自身免疫为主,磁共振影像多表现为楔形病灶和渐进性强化模式,当表现为肿块样时不易确诊,临床病史和影像表现相结合能够帮助诊断CF,诊断困难时还需要通过病理结果确定。

关键词: 肝脏, 磁共振, 体层摄影术, 纤维化, 超声

Abstract: Objective To explore the clinical and imaging features of hepatic confluent fibrosis (CF) in order to increase the diagnostic experience and awareness of the disease. Methods The clinical and imaging data of 19 patients with hepatic confluent fibrosis confirmed by imaging and puncture pathology from October 2023 to October 2024 in the fifth medical center of PLA general hospital were analyzed, and the general data, etiological types and imaging characteristics of the patients were sorted out and summarized. Results The clinical symptoms of 19 CF patients were mainly liver function abnormalities, fatigue, abdominal distension and abdominal pain. 8 patients were drug-induced liver damage and 6 patients were autoimmune liver diseases who were diagnosed by pathology. MR enhanced abdominal scan images showed that 18 patients were single lesions, and lesions were located in the right lobe of the liver in 15 patients. In 6 patients, the liver volume decreased and wrinkling of the liver capsule was seen. The enhancement mode was progressive enhancement, with no obvious enhancement in the arterial stage, and the high signal in the portal stage and delay stage was relatively obvious. Conclusion CF is more common in middle-aged and old women, without specific clinical symptoms, The main pathogenic factors are mainly drug-induced or autoimmune damage, MR images usually show wedge lesions and progressive enhancement pattern, which is not easy to diagnose when showing mass appearance. The combination of clinical history and imaging findings may help to diagnose CF, and pathological results may provide accurate result when the diagnosis is difficult.

Key words: Liver, Magnetic resonance imaging, Tomography, Fibrosis, Ultrasound

刘阳, 刘静, 李志艳, 任洪伟, 张萌萌, 刘树红, 刘长春, 高珅, 刘渊. 肝脏融合性纤维化临床与影像分析[J]. 肝脏, 2025, 30(5): 592-594.

LIU Yang, LIU Jing, LI Zhi-yan, REN Hong-wei, ZHANG Meng-meng, LIU Shu-hong, LIU Chang-chun, GAO Shen, LIU Yuan. The clinical and imaging analysis of confluent hepatic fibrosis[J]. Chinese Hepatolgy, 2025, 30(5): 592-594.

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