CT及MRI特征对多房样肝囊肿与肝黏液性囊性肿瘤的鉴别价值

摘要/Abstract

摘要： 目的探讨CT及MRI特征对多房样肝囊肿与肝黏液性囊性肿瘤(MCN)的鉴别价值。方法选取2022年5月至2024年5月期间我院收治的81例多房样肝囊性病变患者作为研究对象,根据病理结果分为肝囊肿组(n=49)、肝MCN组(n=32)。对比两组患者的一般资料、CT及MRI特征。采用logistic回归分析评估肝MCN病变的影响因素,构建受试者工作特征(ROC)曲线分析CT及MRI特征对肝MCN病变的诊断效能。结果肝MCN组的单发囊性病变、不光滑囊壁及分隔、有囊壁或分隔结节样凸起、实性部分厚度＞10 mm、两端均与囊壁或分隔相连、起自囊壁的占比分别为59.4%、53.1%、43.8%、28.1%、90.6%、81.2%,均高于肝囊肿组(P<0.05)。Logistic回归分析表明,囊性病变数量、分隔类型、分隔与囊壁关系是肝MCN病变的影响因素(P<0.05)。ROC曲线结果表明,囊性病变数量、分隔类型、分隔与囊壁关系联合预测的AUC值为0.897。结论 CT及MRI特征在多房样肝囊肿与肝MCN的鉴别诊断中具有重要价值,其中囊性病变数量、分隔类型及分隔与囊壁关系为主要影像学影响因素,三者联合分析可进一步提高对肝MCN病变的诊断效能。

关键词: CT, MRI, 多房样肝囊肿, 肝黏液性囊性肿瘤

Abstract: Objective To investigate the differential diagnostic value of computed tomography (CT) and magnetic resonance imaging (MRI) features in multilocular hepatic cysts and hepatic mucinous cystic neoplasms (MCN). Methods A total of 81 patients with multilocular hepatic cystic lesions admitted to our hospital from May 2022 to May 2024 were retrospectively included. According to pathological results, the patients were divided into a hepatic cyst group (n=49) and a hepatic MCN group (n=32). The clinical characteristics, CT, and MRI findings were compared between the two groups. Multivariate logistic regression was performed to determine the factors associated with hepatic mucinous cystic neoplasm. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic efficacy of CT and MRI features for hepatic MCN. Results The proportions of single cystic lesions, irregular cyst wall and septa, nodular protrusions of the cyst wall or septa, solid components with thickness >10 mm, septa with both ends connected to the cyst wall and septa originating from the cyst wall in the hepatic MCN group were 59.4%, 53.1%, 43.8%, 28.1%, 90.6%, and 81.2%, respectively, which were significantly higher than those in the hepatic cyst group (P<0.05). Logistic regression analysis showed that the number of cystic lesions, septal type, and the relationship between septa and the cyst wall were influencing factors for hepatic MCN (P<0.05). ROC analysis showed that the combined prediction of the number of cystic lesions, septal type, and the relationship between septa and the cyst wall yielded an AUC of 0.897. Conclusion CT and MRI features have important value in the differential diagnosis of multilocular hepatic cysts and hepatic MCN. The number of cystic lesions, septal type, and the relationship between septa and the cyst wall are the main imaging factors influencing hepatic MCN, and their combined analysis can further improve the diagnostic efficacy for hepatic MCN.

Key words: CT, MRI, Multilocular hepatic cyst, Hepatic mucinous cystic neoplasm

杨肖颖, 杨娜. CT及MRI特征对多房样肝囊肿与肝黏液性囊性肿瘤的鉴别价值[J]. 肝脏, 2026, 31(7): 1010-1014.

Yang Xiaoying, Yang Na. Analysis of the differential diagnostic value of CT and MRI features for multilocular hepatic cysts and hepatic mucinous cystic neoplasms[J]. Chinese Hepatolgy, 2026, 31(7): 1010-1014.

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