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肝脏孤立性坏死结节的影像和病理对照 总被引:19,自引:1,他引:18
目的认识肝脏孤立性坏死结节的影像及病理学表现,提高诊断准确率。方法16例中12例经手术病理证实,4例根据MRI表现随访半年以上证实。对照病理,分析16例超声、CT及MRI表现。结果组织病理显示全部为凝固坏死结节,6个病灶含有小片液化坏死,平均直径2.3cm,外周的薄层纤维包膜中有淋巴细胞、浆细胞、嗜酸性细胞及少数中性白细胞浸润。超声为内部回声欠均匀的低回声结节。CT表现为边缘清楚、无强化的低密度病灶。在MRI的T1及T2WI上分别呈低信号及等低信号,4个病灶内间以点片状更低信号及高信号,增强后病灶内部无强化,44%(7/16)有细环状轻度延迟强化的包膜。结论平扫加动态增强MRI能良好反映孤立性坏死结节的病理特征,其表现具高度的诊断特异性,明显优于超声和CT。 相似文献
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鼻咽癌放射治疗后脑干放射性损伤的MRI表现 总被引:13,自引:1,他引:12
目的探讨鼻咽癌放射治疗后脑干放射性损伤的MRI表现。方法分析51例鼻咽癌经放射治疗后,脑干放射性损伤的MRI自旋回波T1WI及超快速自旋回波T2WI和增强后T1WI表现及临床表现。结果脑干放射性损伤的临床表现为肢体麻木、无力或瘫痪及颅神经损伤症状。MRI显示中脑、脑桥和延髓内呈斑片状改变分别为2、7及3例;脑桥基底部广泛受累9例;脑桥基底部下份及延髓前上份者30例。自旋回波T1WI病灶均呈低或等信号改变;超快速自旋回波T2WI呈等、高信号混杂改变,脑桥水平病灶内高信号呈横行条纹状。增强后扫描显示病灶区无强化者9例,斑点状强化者3例及不规则花环状强化者39例。占位效应与病灶的大小不相称。14例经治疗后MRI复查,4例病灶消失,8例病灶形态及位置无变化,2例病灶增大。结论MRI可显示脑干放射性脑病特征;临床症状与MRI追踪表现可不完全一致 相似文献
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肝脏局灶结节性增生:磁共振成像与病理的对照研究 总被引:3,自引:0,他引:3
目的:研究肝脏局灶结节性增生(FNH)的MRI表现与病理基础,探讨MRI的诊断价值。材料与方法:回顾性分析经病理证实的10例FNH的MRI表现、术前诊断并与病理组织学所见对照。结果:7例诊断为FNH,3例误诊为恶性肿瘤。8例T1加权像呈等或稍低信号,T2加权像为等或稍高信号。7例信号均匀,病变中心或偏心见瘢痕;6例行动态增强扫描,病变动脉期均显著增强、门脉期明显或轻度增强、延迟期瘢痕轻度增强。3例病变邻近的肝被膜皱缩,可见瘢痕中的纤维组织延伸至肝被膜。3例病变内见异常流空血管影。瘢痕的信号与小血管和纤维组织的结构有关。结论:大多数FNH的MRI显示有特征性改变,从而可获得准确诊断 相似文献
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颅脑血管外皮细胞瘤的CT、MRI与病理对照研究 总被引:12,自引:2,他引:10
目的:探讨颅脑血管外皮细胞瘤的临床、病理和CT、MRI特征。材料与方法:收集经CT和MRI诊断为脑膜瘤,经手术病理证实为血管外皮细胞瘤12例,年龄34 ̄58岁。CT检查7例,均采用增强前、后常规扫描。MRI检查12例,采用SE序列增强前、后扫描。结果:12例肿瘤全部发生在颅内脑外,7例CT平扫呈低等混合密度2例,呈等高混合密度5例;增强后扫描呈不均匀强化6例,均匀强化1例。骨窗显示病灶局部侵蚀性骨质破坏4例。MRI平扫,T1WI呈等高不均匀信号10例,呈等信号2例;T2WI呈不均匀等高信号10例,呈等信号2例。12例中7例显示脑膜尾征;增强后扫描1 均呈不均匀强化。结论:血管外皮细胞瘤具有一定的CT、MRI特征性表现:分叶状、丰富的血管流空、肿瘤内密度或信号不均匀、无肿瘤内钙化和骨质增生、局部颅骨呈溶骨性破坏。 相似文献
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恶性脑膜瘤CT与MRI诊断的比较研究 总被引:7,自引:1,他引:6
目的:通过对恶性脑膜瘤的CT,MRI诊断加以比较研究探讨其价值及限度,材料与方法,对术后病理证实的20例恶性脑膜瘤术前同时行CT,MRI检查的影像学特征进行回顾性分析,结果:CT像上,病灶内密度不均匀者8例,增强后不均匀强化者4例,病灶不规则边缘分叶状和/或结节状者12例,肿瘤包膜显示者2例,MRI示肿瘤呈呈不均匀信号者,T1WI13例,T2WI14例;增强后呈不均匀强化者14例,肿瘤不规则边缘呈 相似文献
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磁共振动态增强和脂肪抑制技术在胰腺癌诊断中的价值 总被引:24,自引:3,他引:21
目的 了解磁共振动态增强和脂肪抑制技术在胰腺诊断中的价值。材料与方法 18例经手术病理证实的胰腺癌患者进行了磁共振检查,采用在磁共振序列分别为:SET1WI、FSET2WI、脂肪抑制技术SET1WI和动态增强FMPSPGR等。结果 18例胰腺癌肿瘤病灶,在SET1WI上呈低信号者10例,等信号者6例,高信号者2例;FSET2WI上高信号者8例,等信号者6例,低信号者4例;脂肪抑制技术SET1WI上 相似文献
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目的:探讨颞叶癫痫的MRI 表现及其诊断价值。材料和方法:对临床诊断为颞叶癫痫43 例患者,行自旋回波横断面、冠状面和矢状面MRI 研究。结果:43 例中,35 例颞叶发现有异常MR 信号,并经手术病理证实。8 例颞叶无异常发现。术前MRI 定位诊断正确率为100 % ,定性诊断正确率为82 .9 % 。35 例中,9 例胶质细胞增生,T1 WI上无明显信号异常,T2 加权图像上呈无占位效应的高信号;15 例胶质瘤, 表现为病灶呈长T1 长T2 信号, 并伴有不同程度的占位效应,灶周水肿不明显;7 例胆脂瘤,表现为T1 WI 上呈高于脑脊液的低信号,T2 WI 上均呈高于脑脊液的高信号;4 例海绵状血管瘤,T1 WI 上呈等高混合信号,T2 WI 上呈明显高信号,周边有低信号环与脑实质相隔。结论:MRI 对确定颞叶癫痫病灶的部位和病因具有重要价值。 相似文献
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目的:探讨肝局灶性结节增生(FNH)的典型及不典型MRI表现及与病理特点的相关性,提高FNH诊断的准确性。方法:回顾性分析33例(共40个病灶)经手术病理证实的FNH的MRI平扫和增强表现。结果:28例为单发,5例为多发病灶。40个病灶在T1WI呈等或稍低信号,在T2WI呈等或稍低信号,增强扫描动脉期31个病灶(94%)明显强化,门脉期及延迟期呈稍高或等信号;1例动脉期未见明显强化,门脉期及延迟期可见强化;1例动脉期边缘明显强化,门脉期及延迟期逐渐强化。12个病灶(30%)中心可见纤维瘢痕,11个延迟期强化,1个未见明显强化。3个病灶(8%)边缘见假包膜,延迟期可见强化。结论:MRI能较好地反映FNH内部组织学情况及血供特点,充分认识FNH的典型征象及不典型表现能帮助我们准备地做出诊断,从而避免不必要的活检及手术。 相似文献
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目的 :分析肝脏局灶性结节增生 (FNH)平扫和动态增强的螺旋CT、MRI表现 ,提高FNH诊断符合率。方法 :对 13例经手术病理证实的FNH影像学表现进行回顾性分析。螺旋CT检查 8例 ,MRI检查 6例 ,其中 1例同时做CT和MRI检查。结果 :8例CT平扫病灶均呈低密度 ,均匀或不均匀。增强动脉期扫描除中心疤痕外 ,所有病灶均有明显均匀强化 ,其中 4例还可见到病灶中心或周边增粗、扭曲的动脉。门脉期和延迟期扫描 4例呈略高密度、4例病灶呈等密度或略低密度 ,4例伴有中心疤痕者均有延迟强化。MRI检查 6例 ,病灶均呈不均匀略长或等T1及T2 信号 ,增强动脉期呈明显强化 ,门脉期及延迟期呈等或略高强化 ,4例MRI平扫显示中央瘢痕者有延迟强化。结论 :平扫和动态增强螺旋CT、MRI能较全面显示FNH的病理特征和血供特点 ,明显地提高与其它富血管恶性肿瘤的鉴别诊断能力 相似文献
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肝脏局灶性结节增生的CT和MRI表现与病理对照分析 总被引:3,自引:1,他引:3
目的:探讨肝脏局灶性结节增生(FNH)的CT和MRI表现及病理基础。方法:回顾性分析18例20个经手术或穿刺活检病理证实FNH的CT和MRI表现特点,并与病理对照(CT检查12例,MRI检查10例,4例同时行CT和MRI检查)。结果:病灶大小1.8~13.5cm;CT检出11个病灶,CT平扫病灶均呈低密度,均匀或不均匀;增强扫描动脉期示除中心疤痕灶外,所有病灶均明显增强,6个病灶周边见增粗、扭曲的动脉;门脉期示病灶呈稍高密度,延时期示6个病灶呈稍高或等密度,5个病灶呈稍低密度;5个病灶的中央疤痕均延时增强。MRI检出12个病灶,病灶均呈稍长或等T1及T2信号;增强动脉期示病灶明显增强,门脉期及延时期呈稍高或等信号,7个病灶的中央疤痕延时增强。结论:CT和MRI能够显示FNH的血供特点及病理特征,动态增强扫描是诊断FNH最有效的影像学手段,在诊断和鉴别诊断中具有很大价值。 相似文献
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目的:评价肝局灶性结节增生(FNH)的MRI诊断价值。方法:经手术或穿刺活检病理证实的FNH19例,共21个病灶。全部病例进行了CT和MRI检查,CT检查常规行平扫和双期增强扫描;MRI平扫序列如下:用快速恢复快速自旋回波序列(FRFSE)采集压脂T2W图像,用快速扰相梯度回波序列(FSPGR)采集压脂T1W图像,用真稳态进动梯度回波序列(FIESTA)采集T2/T1比值加权图像,用FSPGR序列同时采集无脂肪抑制的反相位和同相位T1W图像。所有病例均行Gd-DTPA动态增强扫描,其中3例进行细胞特异性对比增强扫描。结果:17个FNH在平扫T2WI fs为等信号或略高信号,在T1WI fs上呈等信号或略低信号。MRI平扫共见中心瘢痕12个、中央粗大血管3条、假包膜数2个,均多于CT平扫所见。Gd-DTPA动态增强扫描时,21个FNH于动脉期均明显强化,16个FNH于门脉期或延迟期的信号强度与肝组织接近,中心瘢痕和假包膜延迟强化。行细胞特异性对比增强扫描的3个FNH实质均明显强化,中心瘢痕无强化。结论:绝大多数FNH在MRI上有特征性的征象,MRI可以明确诊断,MRI对FNH的诊断价值高于CT。 相似文献
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目的 :分析肝脏局灶性结节增生 (FNH )的CT、MR及DSA表现 ,提高对本病的认识。方法 :6例经证实的FNH ,均行CT、MR及DSA检查。结果 :6例病灶CT平扫低密度者 4例 ,均匀或不均匀 ,2例为等密度。增强动脉期所有病灶均有明显强化 ,除中心瘢痕外病灶强化均匀一致 ,3例可见到中心或周边增粗、扭曲的动脉。门脉期和延迟期扫描 4例病灶为等密度 ,2例为略高密度。 3例伴有中心瘢痕 ,1例无强化 ,2例延迟强化。 2例行DSA检查 ,病灶内分布较均匀的新生血管团。MR检查 4例 ,T1 WI呈等信号或略低信号 ,T2 WI呈略高信号。 1例行Gd DTPA增强延迟期呈略高信号 ,中心瘢痕无明显强化。结论 :CT、MR及DSA检查可充分反映FNH的血供特点和病理特征 ,动态增强是诊断FNH最有效的影像学手段 ,在诊断和鉴别诊断中具有很大价值 相似文献
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Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study 总被引:12,自引:0,他引:12
PURPOSE: To prospectively determine the accuracy of differentiating benign focal nodular hyperplasia (FNH) from hepatic adenoma (HA) and liver adenomatosis (LA) by using gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging. MATERIALS AND METHODS: The ethics committee at each center approved the study, and all patients provided informed consent. Seventy-three patients with confirmed FNH and 35 patients with confirmed HA (n = 27) or LA (n = 8) underwent MR imaging before (T2-weighted half-Fourier rapid acquisition with relaxation enhancement or T2-weighted fast spin-echo and T1-weighted gradient-echo [GRE] sequences) and at 25-30 seconds (arterial phase), 70-90 seconds (portal venous phase), 3-5 minutes (equilibrium phase), and 1-3 hours (delayed phase) after (T1-weighted GRE sequences only, with or without fat suppression) bolus administration of 0.1 mmol per kilogram of body weight gadobenate dimeglumine. The enhancement of 235 lesions (128 FNH, 32 HA, and 75 LA lesions) relative to the normal liver parenchyma was assessed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy for the differentiation of FNH from HA and LA were determined. RESULTS: Hyper- and isointensity on T2-weighted and iso- and hypointensity on T1-weighted GRE images were noted for 177 (88.9%) of 199 lesions visible on unenhanced images. On dynamic phase images after contrast material administration, 231 (98.3%) of 235 lesions showed rapid strong enhancement during the arterial phase and appeared hyper- to isointense during portal venous and equilibrium phases. Accurate differentiation of FNH from HA and LA was not possible on the basis of precontrast or dynamic phase images alone. At 1-3 hours after contrast material enhancement, 124 (96.9%) of 128 FNHs appeared hyper- or isointense, while 107 (100%) HA and LA lesions appeared hypointense. The sensitivity, specificity, PPV, NPV, and overall accuracy for the differentiation of FNH from HA and LA were 96.9%, 100%, 100%, 96.4%, and 98.3%, respectively. CONCLUSION: Accurate differentiation of FNH from HA and LA is achievable on delayed T1-weighted GRE images after administration of gadobenate dimeglumine. 相似文献
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肝脏局灶性结节增生的CT和MRI表现与病理对照研究 总被引:7,自引:0,他引:7
目的:探讨肝脏局灶性结节增生(focalnodularhyperplasia,FNH)的CT和MRI表现及病理基础。材料和方法:回顾性分析16例18个病理证实的FNHCT和MRI表现特点并与病理对照(CT检查8例,MRI检查10例,2例同时做CT和MRI检查)。结果:病灶大小2.0~14.5cm;CT检出9个病灶,CT平扫病灶均呈低密度,均匀或不均匀;增强扫描动脉期示除中心疤痕灶外,所有病灶均明显增强,4个病灶周边见增粗、扭曲的动脉;门脉期示病灶呈稍高密度,延时期示5个病灶呈稍高或等密度,4个病灶呈稍低密度;4个病灶的中央疤痕均延时增强。MRI检出11个病灶,病灶均呈稍长或等T1及T2信号;增强动脉期示病灶明显增强,门脉期及延时期呈稍高或等信号,5个病灶的中央疤痕延时增强。结论:CT和MRI能够显示FNH的病理特征及血供特点,提高对FNH的诊断率。 相似文献
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Telangiectatic focal nodular hyperplasia: US,CT, and MR imaging findings with histopathologic correlation in 13 cases 总被引:11,自引:0,他引:11
Attal P Vilgrain V Brancatelli G Paradis V Terris B Belghiti J Taouli B Menu Y 《Radiology》2003,228(2):465-472
PURPOSE: To review the ultrasonographic (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in 13 patients with telangiectatic focal nodular hyperplasia (FNH) and to compare imaging features with histopathologic results from resected specimens. MATERIALS AND METHODS: US, helical multiphasic CT, and MR images in 13 patients with pathologically proven telangiectatic FNH were reviewed retrospectively. Two abdominal radiologists evaluated lesions for number, size, heterogeneity, surface characteristics, presence of a central scar, presence of a pseudocapsule, US appearance, attenuation at CT, signal intensity at MR imaging, and presence of associated lesions. Imaging and pathologic findings were compared. RESULTS: Sixty-one lesions (5-140 mm in diameter) were seen at imaging. Lesions were multiple in eight of 13 (62%) patients. Imaging characteristics were heterogeneity in 26 of 61 lesions (43%), well-defined margins in 43 of 61 (70%), lack of a central scar in 56 of 61 (92%), presence of a pseudocapsule in three of 61 (5%), hyperintensity on T1-weighted MR images in 17 of 32 (53%), strong hyperintensity on T2-weighted MR images in 24 of 54 (44%), and persistent enhancement on delayed contrast material-enhanced CT or T1-weighted MR images in 23 of 38 (61%). No specific US pattern was noted. Two patients had additional lesions: One had classic FNH, and the other had a cavernous hemangioma. Hyperintensity on T1-weighted MR images was due to sinusoidal dilatation. Hyperintensity on T2-weighted MR images correlated well with the presence of inflammation. CONCLUSION: Telangiectatic FNH differs from typical FNH at imaging: Atypical FNH features often observed with telangiectatic FNH are lack of a central scar, lesion heterogeneity, hyperintensity on T1-weighted MR images, strong hyperintensity on T2-weighted MR images, and persistent contrast enhancement on delayed contrast-enhanced CT or T1-weighted MR images. 相似文献
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目的 评估MR诊断肝脏多发局灶性结节性增生(focal nodular hyperplasia,FNH)的价值.方法 回顾性分析经病理证实的9例多发FNH的MR表现,并与部分病灶病理所见对照.结果 9例诊断均考虑到FNH的可能性,5例第一诊断考虑为FNH,3例第一诊断考虑为肝腺瘤,1例第一诊断考虑为纤维板层型肝癌.9例共31个病灶,T2WI 19个呈稍高信号、12个呈等信号;T1WI上12个呈稍低信号、7个呈等信号、12个呈高信号;反相位成像1个病灶局部信号略有减低.注射Gd-DTPA后,动脉期18个病灶轻度至明显不均匀强化、11个病灶显著均匀强化、1个病灶中度不均匀环形强化、1个病灶未见异常强化;门静脉期和延迟期31个病灶均逐渐呈等信号或稍高信号.共16个病灶出现中央瘢痕,瘢痕延迟期强化.结论 多发FNH有特征性表现,大部分病例MR能正确诊断. 相似文献