局限性肝紫癜1例

患者男,51岁。10天前体检B超偶然发现肝内实质性占位,无任何不适。查体：肝脾不大,皮肤巩膜无黄染,浅表淋巴结无肿大。实验室检查：谷丙转氨酶469u／l,谷草转氨酶304u／l。     

含脂肪原发性肝癌的影像学表现

目的:分析含脂肪肝癌的CT和MRI表现。方法:回顾性分析11例含脂肪肝癌的CT和MRI表现。结果:8例含少量脂肪成分,3例含大片脂肪成分,11例均见包膜样结构,7例实质部分呈"快进快出"样强化。结论:包膜样结构和实质部分的快进快出强化有利于含脂肪肝癌的诊断,慢性肝病史和AFP升高有利于与其它肝脏含脂肪病变相鉴别。     

睾丸癌肉瘤影像学表现一例

病例资料 男,81岁,因右侧阴囊内肿物渐大3个月入院.查体:右侧阴囊内可触及一大小约5 cm×6 cm×6.5 cm肿物,有压痛,右侧睾丸触不清.阴囊彩超检查:右侧睾丸实性占位,右侧睾丸鞘膜积液,右侧精索静脉曲张,左侧附睾囊肿.睾丸CT平扫及增强示:右侧鞘膜囊内积液,内见一分叶状软组织影,大小约3.5cm×2.3cm×2.7cm,平扫CT值约47 HU.     

肝灌注异常现象在肝局灶性病变中的MRI表现

目的 分析肝灌注异常信号在各种局灶性肝病中的影像表现,探讨其可能的发生机制.方法 对25例肝内局灶性病变(包括肝脓肿13例,肝细胞癌5例,转移瘤4例,血管瘤2例,胆管细胞癌1例)MRI平扫及增强扫描中出现的肝灌注异常信号进行回顾性分析.结果 25例肝灌注异常均表现为T2WI病灶周围楔形或不规则形稍长T2信号、或增强扫描一过性肝段性强化,其中肝叶、多段型16例,扇型8例,弥漫型1例.12例MR检查前已行CT增强扫描并见动脉期一过性肝段强化,无论MR强化还是CT强化其强化形态和范围均与T2WI肝段性长T2信号一致.25例肝灌注异常,发生门静脉分支受压12例,门静脉癌栓4例,肝静脉癌栓1例,动-门静脉分流1例.结论 肝灌注异常信号是反映潜在肝病变的一个重要征象,与病灶虹吸作用、门静脉癌栓闭塞、动-门静脉分流等因素有关.     

原发性肝类癌的CT及MRI表现

目的 探讨原发性肝类癌的CT及MRI表现.方法 回顾性分析2003年12月至2008年11月间11例经手术病理证实的原发性肝类癌患者资料.4例行CT检查,8例行MRI检查,分析其影像表现特征.结果 11例中肿瘤多发2例,表现为2个或2个以上的结节状病灶,其余9例均为单发.CT检查4例患者病灶均表现为平扫边界清楚低密度,中心可见不规则更低密度区;增强后动脉期病灶实质部分不均匀强化,中心更低密度区无强化,门静脉期及延迟期病灶边缘仍轻度强化,强化程度较动脉期减低,中心坏死区始终无强化.MRI 8例患者中7例T_1WI表现为边界清楚的不均匀低信号,T_2WI病灶呈高信号,中心可见不规则低信号;增强后动脉期病灶边缘不均匀强化,病灶中心可见不规则无强化低信号区,门静脉期及延迟期病灶边缘仍轻度强化,边缘显示不清,病灶中心无强化低信号区范围较动脉期缩小.1例患者T_1WI表现为边界清楚的囊状低信号影,囊内可见高信号,T_2WI病灶呈高信号;增强后动脉期病灶边缘不均匀强化,门静脉期及延迟期呈低信号.结论 平扫和动态增强CT扫描及MRI能反映原发性肝类癌的影像特点,具有一定特征性.     

肝豆状核变性的肝影像学表现

目的 :探讨肝豆状核变性的肝脏影像特征及早期诊断的可能性。方法 :对 17例有临床症状 ,经眼角膜检查、血铜检测、CT表现及进行驱铜治疗后所确诊的肝豆状核变性患者进行回顾性分析。结果 :17例中 15例有结节性肝硬化表现 ,1例出现肝脂肪变性伴门脉高压征象 ;肝内结节呈弥漫分布 ,稍高或高密度 ,边界清楚 ;随病程发展结节逐渐增大 ,密度增高 ,肝脏体积缩小。结论 :年青患者尤其是少儿期出现结节性肝硬化或脂肪变性 ,在排除病毒感染后应考虑本病的可能 ,肝影像学表现是早期诊断无神经系统锥体外系症状的肝豆状核变性的重要依据之一。     

肝脏囊虫感染的影像学表现

目的 探讨肝脏囊虫感染的影像学特征.方法 搜集8例患者临床及影像学资料,分析病灶分布、数量、大小、形态、密度/信号、强化方式及胆管扩张、脾大、淋巴结肿大、腹腔积液等影像学特点.结果 8例均为多发病灶,4例累及肝脏多叶,呈“簇样”不规则圆形/类圆形、结节状或蜂窝样表现,沿门静脉走行为主分布于肝脏深部或包膜下近肝表面,最大...     

乳头状肾细胞癌的影像学表现

目的：研究乳头状肾细胞癌（RCC）的影像学表现,以提高对其诊断的准确性。方法：回顾性分析经手术病理证实的8例乳头状肾细胞癌的患者的影像资料。结果：8例患者共13个肿瘤病灶,7例12个病灶位于右肾,1例位于左肾。肿瘤均呈膨胀性生长,最大径为0．2～8．0cm,8个病灶≤4cm者。CT、MRI表现为平扫肿瘤密度／信号较均匀,内有灶状出血（4／13）、坏死（4／13）和钙化（1／13）,增强扫描肿瘤呈较均匀或不均匀强化,肾皮髓期、实质期和排泄期强化程度明显弱于肾皮质,弱于或相仿于肾髓质。4个病灶显示完整或较完整的假包膜。结论：乳头状肾细胞癌的影像学表现有一定特征性,膨胀性生长方式,瘤内可有灶状出血、坏死和钙化,CT和MRI增强扫描肿瘤边缘清楚,持续轻度强化,增强三期扫描中其强化程度均弱于或相仿于肾髓质,有助于同其它类型RCC鉴别。     

局灶性肝紫癜的CT及MRI表现

【摘要】目的：探讨局灶性肝紫癜（FPH）的CT及MRI表现。方法：回顾性分析6例经病理证实的局灶性肝紫癜患者的临床资料及CT图像，其中2例同时行MRI检查。图像分析包括病灶的数目、部位、大小、形态、CT及MR平扫以及强化特征等。结果：6例患者中，男3例，女3例，年龄（52.8±9.9）岁； 5例为单发病灶， 1例有2个病灶。病灶位于肝右叶5个，肝左叶2个；边界模糊6个，边界清晰1个；平均直径（长径与短径之和的平均值）9.5~23.0mm，均值（15.5±5.3）mm。CT平扫：病灶均呈略低密度，平均CT值为（44.3±13.0）HU，邻近肝实质平均CT值为（57.3±7.3）HU，两者间的差异有统计学意义（P<0.05）。CT增强扫描：病灶均呈渐进性强化，其中4个呈均匀轻度强化，2个呈离心性强化，1枚呈轻度环形强化；动脉期及静脉期，病灶平均CT值分别为（58.0±9.7）和（80.4±15.9）HU，邻近肝实质分别为（75.9±9.4）和（102.3±10.4）HU，两期图像上病灶与邻近肝实质间的差异均有统计学意义（P<0.05）。2个病灶在MR平扫T2WI上呈稍高信号，T1WI上呈低信号，增强后呈渐进性强化。结论：局灶性肝紫癜的主要CT表现为肝内边界模糊的低密度病灶，增强扫描呈渐进性强化。     

肝脏囊性病变的分类及影像学表现

【摘要】肝脏囊性病变种类繁多,影像表现多有重叠,鉴别诊断具有难度。本文分析了不同囊液的基本影像表现,将肝脏囊性病变分为先天性、感染性、肿瘤性和创伤性四大类,系统介绍各类囊性病变的疾病谱及影像学表现,旨在提高该病的影像诊断水平。     

肝紫癜病一例

患者 男,31岁.2个月前自觉腹胀,于餐后明显,体质量减轻约5 kg.既往有痛风病史3个月,服用"苯溴马隆"药物治疗(剂量不详).     

血管母细胞瘤型脑膜瘤影像表现(附1例报道)

血管母细胞瘤型脑膜瘤是脑膜瘤的一种特殊类型,查阅国内、外近年文献,关于其病理表现及病理归属讨论较多,而影像表现报道很少。我们遇到1例,现报道分析如下。患者,女,59岁,头痛1个月,加重并伴恶心,呕吐2d就诊。影像学检查:a)CT平扫示左顶叶低密度病变,内部密度不均,有小点状高密度影,周围水肿明显,局部脑沟、脑回显示不清,右侧脑室前角受压变形(见图1),考虑胶质瘤可能性大。回顾性读片时,骨窗观察可见局部颅骨轻度增厚。b)M RI成像,左顶部见一类圆形病灶,边界清楚,大小约4.6cm×5.8cm,平扫呈不均匀的长T1长T2异常信号,病灶邻近脑白质大片…     

肺淀粉样物质沉积症影像表现一例

本文报道肺淀粉样物质沉积症影像表现1例。患者,男,61岁,胸部CT表现为右肺下叶后基底段团块样占位影,大小约30 mm×40 mm,边界清楚,边缘不规则,密度均匀,CT值约43 HU,增强扫描未见明显强化。病理诊断:考虑肺淀粉样物质沉积症。     

Unusual cross-sectional imaging findings in hepatic peliosis

Hepatic peliosis is a rare entity that represents focal, multifocal, segmental, or diffuse dilatation of liver sinusoids. Hepatic peliosis is often associated with chronic wasting diseases but also has been reported in association with anabolic, contraceptive, or other hormonal treatment, and even in context with HIV-related bacterial infections. Hepatic peliosis is usually clinically unapparent and mostly found only during autopsy, but occasionally it may lead to diagnostic problems if detected radiologically since the imaging findings in hepatic peliosis are quite variable according to the variety of its possible histologic features as well as the possibility of additional hemorrhage. We present a case of hepatic peliosis associated with bronchial carcinoma that showed moderate centripetal enhancement during the portal-venous phase on CT, pronounced venous pooling on contrast enhanced T1-weighted images acquired during the hepatic-venous phase, and bright signal on T2-weighted images, thus mimicking in some way a capillary hemangioma. We also discuss some not yet described CT and MR features of this rare entity which should be included into the differential diagnosis of atypical liver lesions in patients with the above-mentioned conditions.     

肺泡性腺瘤的影像表现一例

患者男,58岁.因心律失常心脏起搏器植入术前X线胸片发现肺部肿块,于2009年10月19日就诊,主诉反复头晕10余年,眩晕2年.既往无咳嗽、咯痰、气急、胸痛等呼吸系统症状.体检示两肺呼吸音清,心率60次/min,律不齐,未闻及病理性杂音.动态心电图示阵发性房颤伴部分心室长间歇.     

Imaging findings of Nasu–Hakola disease: a case report

Nasu–Hakola disease (NHD), also known as polycystic lipomembranous osteodysplasia and sclerosing leukoencephalopathy, is a rare and fatal hereditary disease with less than 200 cases reported in the literature [Madry H, Prudlo J, Grgic A, Freyschmidt J. Nasu–Hakola disease (PLOSL): report of five cases and review of the literature. Clin Orthop Relat Res 2007;454:262–269]. This progressive disease is characterized by multiple cystic bone lesions, complicated with pathologic fractures and progressive dementia. Here in this article we report the imaging findings including magnetic resonance imaging of a newly diagnosed NHD case, with emphasis on the awareness of the radiologist for prompt recognition of this rare entity.     

Case report: hepatic ultrasound findings in a case of toxocariasis.

Multiple hypoechoic areas within the liver may be caused by a large variety of disorders. We report a case of Toxocara infestation which produced such an appearance within the liver of an 18-month-old child. We believe that this is the first report of Toxocara granulomata detected by ultrasound, and suggest that ultrasound examination may provide a useful diagnostic clue to this disease.     

Imaging findings of primary well-differentiated liposarcoma of the liver: a case report

Primary liposarcoma of the liver is extremely rare. We report here on a case of primary well-differentiated liposarcoma in the left hepatic lobe of a 63-year-old woman. Abdominal ultrasonography showed a well-defined, echogenic, round mass. Abdominal computed tomography (CT) and magnetic resonance (MR) images showed an almost fatty, lobulated mass with a few, random distributed vascular structures and a small area of nodular enhancement. The resected tumor appeared as a well-defined, round, tan-yellow mass. Histological analysis showed a well-differentiated liposarcoma.