MRI对肝孤立性坏死结节诊断及鉴别诊断价值研究*

doi:10.3969/j.issn.1672-5069.2019.01.034

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (1): 129-132.doi: 10.3969/j.issn.1672-5069.2019.01.034

MRI对肝孤立性坏死结节诊断及鉴别诊断价值研究^*

李鹏, 刘小丽, 喻奇志

410005 长沙市第一医院放射科（李鹏,喻奇志）; 内蒙古医科大学附属医院超声科（刘小丽）

收稿日期:2018-07-28 出版日期:2019-01-10 发布日期:2019-01-16
通讯作者: 喻奇志,E-mail:gujuan567@163.com
作者简介:李鹏,男,36岁,硕士研究生,主治医师。主要从事骨骼肌肉医学影像学诊断研究。E-mail:bjzzcb88@163.com
基金资助:
*湖南省自然科学基金资助项目（编号：4273339）

Value of MRI in diagnosis of patients with solitary necrotic node of liver

Li Peng, Liu Xiaoli, Yu Qizhi.

Department of Radiology,First Hospital,Changsha 410005,Hunan Province,China

Received:2018-07-28 Online:2019-01-10 Published:2019-01-16

摘要/Abstract

摘要： 目的探讨使用磁共振成像（MRI）平扫和增强扫描检查肝脏孤立性坏死结节（SNNL）的影像学特征。方法 2013年3月~2017年3月我院收治的43例SNNL患者,全部接受MRI检查,分析病灶的表现特征。结果在43例SNNL病灶中,病灶直径为（2.8±0.4） cm ,其中38个病灶≤3 cm,5个病灶>3 cm;39个为单发病灶,4个为融合型病灶;36个病灶位于肝右叶,7个病灶位于肝左叶;34个为浅表部位病灶,9个为深部病灶;27个病灶为不规则形,16个为圆形或类圆形;T1WI显示32个病灶呈低信号,6个病灶呈稍低信号,5个呈等信号;T2WI 显示2个病灶呈高信号或稍高信号,39个呈等信号,其中4个病灶中可见片状或斑点状高信号;DWI 序列显示21个病灶呈等信号,22个呈高信号或稍高信号;43例在增强扫描后病灶内部均未见强化,且均呈低信号。结论 MRI 平扫和动态增强扫描能较准确地发现 SNNL的特征表现,可为临床诊断提供重要的参考依据。

关键词: 肝脏孤立性坏死结节, 磁共振成像, 影像学特征, 诊断

Abstract: Objective To summarize the imaging features of solitary necrotic nodules of liver （SNNL）. Methods The imaging data of 43 patients with SNNL in our hospital between March 2013 and March 2017 were retrospectively analyzed. The abdominal MRI scan and enhanced examination were performed to observe the imaging features. Results In 43 SNNL lesions,the diameter was（2.8±0.4） cm,with 38 lesions less than and 5 greater than 3 cm;39 were a single focci and 4 were fusion lesions;36 lesions were located in the right,and 7 in the left lobe of the liver;34 lesions were superficial,and 9 were deep lesions;27 lesions were irregular,while 16 were round or round-like;32 lesions showed low signal intensity,6 showed slightly low signal intensity,and 5 lesions showed iso-signal intensity on T2WI;there were 2 lesions with slightly high signal intensity,and 39 lesions with isointensity on T2WI;21 lesions with equal signal intensity and 22 lesions with high signal intensity or slightly hyperintense signal intensity on DWI sequences;in 43 cases,no enhancement was found in the lesions after enhanced scanning. Conclusions MRI plain scan and dynamic contrast enhancement might provide relatively special imaging feature of SNNL,by which the clinicians could make decision for proper management in this setting.

Key words: Solitary necrotic nodules of liver, MRI, imaging features, Diagnosis

李鹏, 刘小丽, 喻奇志. MRI对肝孤立性坏死结节诊断及鉴别诊断价值研究^*[J]. 实用肝脏病杂志, 2019, 22(1): 129-132.

Li Peng, Liu Xiaoli, Yu Qizhi.. Value of MRI in diagnosis of patients with solitary necrotic node of liver[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(1): 129-132.

参考文献

[1] Pananwala H,Pang TC,Eckstein RP,et al.The enigma of solitary necrotic nodule of the liver. Anz J Surg,2014,84(4):260-265.
[2] Kang MW,Tay TKY,Poh WT,et al.Solitary necrotic nodule of the liver:radiologic-pathologic correlation in a case with unusual imaging features. Jpn J Radiol,2013,31(4):277-281.
[3] Yang WM,Yu XL,Jie TM,et al.Solitary necrotic nodule of the liver:Contrast-enhanced sonography. J Clin Ultrasound,2010,35(4):177-181.
[4] 李晶,唐少珊,于宏伟. 超声造影在单发转移性肝癌与肝脏孤立性坏死结节鉴别诊断中的价值. 临床肝胆病杂志,2016,32(7):1338-1341.
[5] Li G.Solitary necrotic nodule of the liver:MR findings in 33 pathologically proved lesions. Eur J Radiol,2012,81(4):623-629.
[6] Ge M,Zhang J,Wu B,et al.Effect of gadolinium on hepatic fat quantification using multi-echo reconstruction technique with T2 correction and estimation. Eur Radiol,2016,26(6):1913-1920.
[7] 胡中华,周科峰,孔晓健,等. 肝内周围型胆管细胞癌MRI表现. 中国CT和MRI杂志,2016,14(10):86-88.
[8] Choi CS,Cho EY,Jeong JS,et al.Spontaneous regression of a solitary necrotic nodule of the liver. Hepatol Int,2010,4(3):649-652.
[9] 邵丹丹,王雪雪,赵骞,等. 肝脏孤立性坏死结节的MRI和CT诊断及鉴别诊断. 放射学实践,2015,30(8):845-848.
[10] Tsui WM,Yuen RW,Chow LT,et al.Solitary necrotic nodule of the liver:parasitic origin. J Clin Pathol,1992,45(11):975-978.
[11] Patti R,Cabibi D,Sparacello M,et al.Solitary necrotic nodule of the liver:different pathological findings express a different histogenesis. Case Rep Gastroenterol,2008,2(1):149-154.
[12] Berry CL.Solitary“necrotic nodule” of the liver:a probable pathogenesis. J Clin Pathol,1985,38(11):1278-1279.
[13] Chen CJ,Chou SC,Chen HJ,et al.Solitary necrotic nodule with larval infestation in the liver on 18F-FDG PET/CT. Clin Nucl Med,2010,35(9):724.
[14] Wang LX,Liu K,Lin GW,et al.Solitary necrotic nodules of the liver:Histology and diagnosis with CT and MRI. Hepat Mon,2012,12(8):e6212.
[15] Colagrande S,Politi LS,Messerini L,et al.Solitary necrotic nodule of the liver:imaging and-correlation with pathologic features. Abdominal Imag,2003,28(1):41-44.
[16] 俞顺,方主亭,包强,等. 肝脏孤立性坏死结节的MRI特征与病理对照. 中国医学影像学杂志,2013,21(9):641-643.
[17] Qian H,Li S,Ming J,et al.MRI characteristics for the differential diagnosis of benign and malignant small solitary hypovascular hepatic nodules. Eur J Gastroenterol Hepatol,2016,28(7):749-756.
[18] 林光武,欧阳汉,周纯武,等. 肝脏孤立性坏死结节的MR表现. 中华放射学杂志,2007,41(10):1073-1076.
[19] 姜英,常晓燕. 肝脏孤立性坏死结节的临床病理分析. 中华肝胆外科杂志,2007,13(9):591-593.
[20] Kim TK,Lee KH,Khalili K,et al.Hepatocellular nodules in liver cirrhosis:contrast-enhanced ultrasound. Abdom Imaging,2011,36(3):244-263.
[21] Lee JM,Choi BI.Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom Imaging,2011,36(3):282-289.
[22] Au-Yeung AW,Luk WH,Lo AX.Imaging features of colorectal liver metastasis in FDG PET-CT:a retrospective correlative analysis between CT attenuation and FDG uptake. Nucl Med Communicat,2012,33(4):403-407.
[23] De LM,Luigi B,Formisano C,et al.Solitary necrotic nodule of the liver misinterpreted as malignant lesion: considerations on two cases. J Surg Oncol,2015,74(3):219-222.
[24] Fang J,Ma X,Yu D,et al.Specific imaging characteristic of solitary necrotic nodule of the liver:Marked peripheral rim-like enhancement with internal hypointensity on longer delayed MRI. Eur Radiol,2017,27(9):1-11.
[25] 张国柄,徐江海. 联合CA19-9、CA125和CEA检测在AFP阴性的ICC鉴别诊断中的应用价值. 实用肝脏病杂志,2017,20(6):740-743.
[26] Lim JH,Lee JH.Inflammatory pseudotumor of the liver. Ultrasound and CT features. Clin Imaging,2015,19(1):43-46.

MRI对肝孤立性坏死结节诊断及鉴别诊断价值研究^*

Value of MRI in diagnosis of patients with solitary necrotic node of liver

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	中国研究型医院学会肝病专业委员会, 中国医师协会脂肪性肝病专家委员会. 脂肪性肝病诊疗规范化的专家建议（2019年修订版）[J]. 实用肝脏病杂志, 2019, 22(6): 787-792.
[2]	. 肝纤维化诊断及治疗共识（2019年）[J]. 实用肝脏病杂志, 2019, 22(6): 793-803.
[3]	吴海义, 陈建新. 四种诊断模型诊断乙型肝炎病毒携带者肝纤维化的效能分析^*[J]. 实用肝脏病杂志, 2019, 22(6): 832-835.
[4]	曹策, 郁义星, 王贝贝, 赵卫峰. 增强磁共振成像联合血清甲胎蛋白和脱-γ-羧基凝血酶原诊断肝细胞癌临床价值探讨[J]. 实用肝脏病杂志, 2019, 22(6): 896-899.
[5]	曾艳妮, 张灿, 毕俊英, 刘良进, 孟俊, 秦涛. MRI长时间延迟增强扫描诊断肝脏孤立性坏死性结节价值研究^*[J]. 实用肝脏病杂志, 2019, 22(6): 900-903.
[6]	邢昊, 韩骏, 杨田. 应用血清PIVKA-II诊断肝细胞癌研究进展^*[J]. 实用肝脏病杂志, 2019, 22(6): 934-937.
[7]	梁巨波, 苗琪, 马雄. 胆管细胞型胆汁淤积诊治进展[J]. 实用肝脏病杂志, 2019, 22(6): 941-943.
[8]	高伟, 侯勇. 肝脏硬度值检测诊断慢性乙型肝炎患者肝组织纤维化的效能分析*[J]. 实用肝脏病杂志, 2019, 22(5): 652-655.
[9]	黄汉军, 鲁凤荣, 张灿. 基于Exchange血流动力学模型的MRI扫描参数诊断肝硬化临床价值分析*[J]. 实用肝脏病杂志, 2019, 22(5): 696-699.
[10]	金良红, 李兴杰, 关红博, 麻少辉. 双能量CT碘定量结合动态对比增强MRI评估肝硬化患者肝脏血流动力学和肝功能临床价值研究*[J]. 实用肝脏病杂志, 2019, 22(5): 712-715.
[11]	洪佳, 吴晓宁, 尤红. 胆汁淤积性肝病的规范化诊断[J]. 实用肝脏病杂志, 2019, 22(5): 758-760.
[12]	程华, 鞠辉, 宋德顺, 李伟. 慢性乙型肝炎患者血清血管生成素样蛋白2和高尔基体蛋白73水平变化及其诊断显著肝纤维化的效能分析^*[J]. 实用肝脏病杂志, 2019, 22(4): 494-497.
[13]	余英芳, 温生宝. 应用磁共振DWI单指数、双指数和拉伸指数模型参数评估慢性乙型肝炎患者肝纤维化程度效能研究^*[J]. 实用肝脏病杂志, 2019, 22(4): 502-505.
[14]	张亚飞, 叶珺, 谢琴秀, 邹桂舟, 李家斌, 李旭, 张振华. 不同医院无创性肝纤维化指标预测慢性乙型肝炎患者肝纤维化效能差异分析^*[J]. 实用肝脏病杂志, 2019, 22(4): 510-513.
[15]	谢晓, 刘婷, 董志霞, 夏幼辰, 张启迪, 曲颖, 蔡晓波, 徐铭益, 陆伦根. FibroTouch检测肝脏受控衰减参数对肝脂肪变的诊断价值分析^*[J]. 实用肝脏病杂志, 2019, 22(4): 526-529.