肝脏多灶性结节状脂肪浸润的CT和MRI诊断

发布时间：2018-06-03 00:11

本文选题：局灶性脂肪变性 + 类肿瘤样　；参考：《临床放射学杂志》2015年11期

【摘要】：目的探讨肝脏多灶性结节状脂肪浸润(HMNFI)的CT和MRI影像表现。方法回顾性分析5例经穿刺活检或通过随访证实为HMNFI患者的CT及MRI资料。全部患者均行CT和MRI平扫及动态增强扫描。结果5例患者CT表现为肝实质内散在分布的多发结节状病灶,大小不等,无占位效应,平扫呈欠均匀低或稍低密度,边界清楚或稍模糊,部分边缘可见环形极低密度影包绕,动态增强扫描其强化方式类似肝实质,强化程度始终低于或于门静脉期及平衡期等强于正常肝实质。MRI T1WI同相位上病灶呈等信号,反相位上呈低或稍低信号,部分边缘可见环形低信号,T2WI及扩散加权成像(DWI)上表现为等或稍高信号,动态增强扫描表现与CT类似。结论HMNFI的CT及MRI影像表现有一定特点,尤其是MRI T1加权反相位图像具有特征性,有助于与肝内真性肿瘤进行鉴别。
[Abstract]:Objective to investigate the CT and MRI findings of hepatic multi-focal nodular fat invasion (HMNFI). Methods CT and MRI findings of 5 patients with HMNFI confirmed by puncture biopsy or follow-up were retrospectively analyzed. All patients underwent plain CT and MRI scan and dynamic enhanced scan. Results the CT findings of 5 cases showed multiple nodular lesions scattered in the hepatic parenchyma with different size and no space occupying effect. The plain scan showed less homogeneous or slightly lower density, the boundary was clear or slightly blurred, and some of the edges were surrounded by circular very low density shadow. Dynamic contrast-enhanced scanning was similar to hepatic parenchyma, and the enhancement degree was always lower than that of normal hepatic parenchyma in the phase of portal vein and equilibrium. MRI showed the same signal in the same phase and low or slightly low signal in inverse phase. At some edges, circular hypointensity T _ 2WI and diffusion-weighted imaging (DWI) showed iso-or slightly high signal intensity, and dynamic contrast enhanced imaging was similar to that of CT. Conclusion CT and MRI images of HMNFI have some characteristics, especially MRI T 1 weighted inverse phase images, which is helpful to differentiate true hepatic tumors.
【作者单位】：昆明医科大学第三附属医院(云南省肿瘤医院)放射科;
【分类号】：R445.2;R816.5;R575

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