MRI对肝孤立性坏死结节诊断及鉴别诊断价值研究*

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。

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

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.