肝脏硬化性血管瘤的CT、MRI影像学特征分析
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摘要
目的探讨肝脏硬化性血管瘤的CT、MRI影像学特征。方法收集我院收治的80例肝脏硬化性血管瘤患者临床资料。所有患者首先接受CT扫描,层厚及层间相隔5mm,CT扫描后进行重建,重建层厚与层间距离为5mm,5例患者行增强扫描,静脉注射典比乐60-75ml,动脉期后行门脉期及延迟期扫描。CT扫描结束后,静休4-5h,再接受MRI扫描。收集肝脏的横断位T1WI、T2WI,并行脂肪抑制序列,注射扎喷酸葡胺0.1mmol/kg,进行增强扫描,参数同上,层厚约为6mm,图像采集矩阵为256×256。结果平扫结果显示,所有病灶均为低密度,门脉期病灶未有强化影像,延时扫描结果发现98%的病灶无强化,2%病灶强化明显,不均匀强化。MRI病灶部位:有96个病灶,其中85.42%病灶在肝右叶,10.42%病灶在肝左叶,3.13%在尾叶,3.13%在方叶。单发病灶有78.13%,多发病灶有11.46%。25.00%的肿瘤直径<2cm,5.21%肿瘤直径2-3cm,97.29%肿瘤直径4-5cm,8.33%肿瘤直径>5cm。边界不清T1WI低信号,T2wI则为不均匀高、低混杂信号,且内部仍见低信号区。MRI微小病灶检出率显著高于CT(P<0.05),误诊率低于CT(P<0.05)。结论肝脏硬化性血管瘤病灶多分布于肝右叶,MRI较CT更能检出微小病灶,从而提高肝脏硬化性血管瘤病灶检出率。
Objective To investigate the CT and MRI imaging features of hepatic sclerosing hemangioma. Methods The clinical data of 80 patients with hepatic sclerosing hemangioma admitted to our hospital were collected. All patients received the CT scan with 5 mm slice thickness and reconstructed 5 mm slice thickness, followed by the enhanced scan. After receiving intravenous injection of 60～75 ml iopamidol, the enhancement pattern at hepatic arterial phase, portal venous phase and delayed phase were carried out. 4～5 h later, patients received the MRI examinations. Thereafter, the appearance on the transversal T1 WI and T2 WI with and without fat suppression was obtained. Then the enhanced scan was performed after the injection of glucosamine glucosamine 0.1 mmol/kg with the same parameters as above, the thickness was 6 mm and the matrix was 256×256. Results The plain scan showed that all lesions were of low density, and no enhanced image was found at the portal venous phase; While at the delayed phase, 98% of lesions were not enhanced, 2% lesions were unevenly enhanced. The MRI showed that there were 96 lesions, of which 85.42% lesions were located in the right lobe of the liver, 10.42% lesions were in the left lobe of the liver, 3.13% were in the caudate lobe and 3.13% were in the quadrate lobe. The single lesions were found in 78.13% and the 11.46% were multiple lesions. The tumor diameter of <2 cm, 2～3 cm, 4～5 cm and >5 cm accounted for 25.00%, 5.21%, 97.29% and 8.33%, respectively. The edge was unclear with low signal on T1 WI and uneven mixed signal on T2 WI. The detection rate of microcarcinoma was significantly higher in MRI than that of CT(P<0.05), and the misdiagnosis rate was lower than that of the CT(P<0.05). Conclusion The lesions of hepatic sclerosing hemangioma are mostly distributed in the right lobe of the liver. Compared with the MRI, the CT has high detection rate of the microcarcinoma.
Objective To investigate the CT and MRI imaging features of hepatic sclerosing hemangioma. Methods The clinical data of 80 patients with hepatic sclerosing hemangioma admitted to our hospital were collected. All patients received the CT scan with 5 mm slice thickness and reconstructed 5 mm slice thickness, followed by the enhanced scan. After receiving intravenous injection of 60～75 ml iopamidol, the enhancement pattern at hepatic arterial phase, portal venous phase and delayed phase were carried out. 4～5 h later, patients received the MRI examinations. Thereafter, the appearance on the transversal T1 WI and T2 WI with and without fat suppression was obtained. Then the enhanced scan was performed after the injection of glucosamine glucosamine 0.1 mmol/kg with the same parameters as above, the thickness was 6 mm and the matrix was 256×256. Results The plain scan showed that all lesions were of low density, and no enhanced image was found at the portal venous phase; While at the delayed phase, 98% of lesions were not enhanced, 2% lesions were unevenly enhanced. The MRI showed that there were 96 lesions, of which 85.42% lesions were located in the right lobe of the liver, 10.42% lesions were in the left lobe of the liver, 3.13% were in the caudate lobe and 3.13% were in the quadrate lobe. The single lesions were found in 78.13% and the 11.46% were multiple lesions. The tumor diameter of <2 cm, 2～3 cm, 4～5 cm and >5 cm accounted for 25.00%, 5.21%, 97.29% and 8.33%, respectively. The edge was unclear with low signal on T1 WI and uneven mixed signal on T2 WI. The detection rate of microcarcinoma was significantly higher in MRI than that of CT(P<0.05), and the misdiagnosis rate was lower than that of the CT(P<0.05). Conclusion The lesions of hepatic sclerosing hemangioma are mostly distributed in the right lobe of the liver. Compared with the MRI, the CT has high detection rate of the microcarcinoma.
引文
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[14]赵秀丽,胡儒华,王平怀,等.肝脏血管周上皮样细胞瘤的CT和MRI表现[J].中国医学影像学杂志,2016,24(9):669-673.
[15]Chan K M,Wu T H,Wu T J,et al.Bioinformatics microarray analysis and identification of gene expression profiles associated with cirrhotic liver[J].Kaohsiung Journal of Medical Sciences,2016,32(4):165-176.
[2]殷灿,虞浩,陆菲菲,等.肺硬化性血管瘤MSCT表现特征及病理学基础[J].中国CT和MRI杂志,2017,15(3):58-61.
[3]周洁洁,许化致,周晓军,等.肝脏血管平滑肌脂肪瘤的CT及MRI影像特征[J].中华肝胆外科杂志,2016,22(2):82-85.
[4]陈立忠,徐敬峰.胃肠道间质瘤肝脏转移灶的CT和MRI特点[J].医学影像学杂志,2017,27(2):292-295.
[5]徐少真,潘江峰.肝血管平滑肌脂肪瘤的MRI与CT影像表现[J].医学影像学杂志,2016,26(4):658-661.
[6]刘鸿明,赖灿,谢晓红.15例肝脏血管平滑肌脂肪瘤的CT、MRI和US表现回顾性分析[J].中华全科医学,2016,14(11):1921-1923.
[7]江海涛,刘璐璐,郑国华,等.乏脂肪型肝脏血管平滑肌脂肪瘤CT和MRI表现分析及鉴别诊断文献复习[J].肿瘤学杂志,2018,24(3):235-239.
[8]韩丽珠,李绪斌.脾硬化性血管瘤样结节性转化的诊断分析[J].国际医学放射学杂志,2017,40(3):326-329.
[9]李若坤,林慧敏,严福华,等.肝脏上皮样血管内皮瘤的临床病理特征及CT/MRI表现[J].中国医学计算机成像杂志,2017,23(4):333-337.
[10]赵桂玖,王明亮,ZHAOGui-jiu,等.肝脏黏液性囊性肿瘤CT和MRI表现[J].中国CT和MRI杂志,2016,14(8):7-10.
[11]李春宏,苏凯,罗康新.肝脏Ⅳ病变肿瘤的MRI影像学特征及诊断价值研究[J].中国CT和MRI杂志,2016,14(10):83-85.
[12]李晓明,陈伟,胡晓飞,等.肌瘤型肝脏血管平滑肌脂肪瘤的CT和MRI特征[J].中华消化外科杂志,2017,16(9):967-972.
[13]李俊,帅存勇.肝硬化及其继发性改变的CT影像学特征研究[J].中国CT和MRI杂志,2016,14(4):68-70.
[14]赵秀丽,胡儒华,王平怀,等.肝脏血管周上皮样细胞瘤的CT和MRI表现[J].中国医学影像学杂志,2016,24(9):669-673.
[15]Chan K M,Wu T H,Wu T J,et al.Bioinformatics microarray analysis and identification of gene expression profiles associated with cirrhotic liver[J].Kaohsiung Journal of Medical Sciences,2016,32(4):165-176.