肝脏囊性转移瘤的CT和MR征象的比较

目的:分析肝脏囊性转移瘤在CT和MR上的表现,比较CT和MR检查对囊性转移瘤的临床诊断价值.材料和方法:18例(共52个病灶)肝脏囊性转移瘤中10例行CT平扫和增强门脉期扫描.8例行MR T1WI和FMP-SPGR多期动态增强扫描.观察肿瘤的大小、形态、数目、囊壁和壁结节的强化情况.结果:2例为单发病灶外,其余均为多发病灶.病灶呈类圆形或椭圆形.CT上8例见到囊壁不规则增厚,其中6例可见向囊腔内突起的壁结节,1例内有分隔.2例薄壁且均匀的病灶误诊为肝囊肿.T1WI上,7例为低信号,1例为混杂信号.T2WI上,病灶均为明显高信号,2例信号均匀,6例信号不均匀,可见到壁结节为略低信号.增强动脉期所有病灶均无强化表现,门脉期和延迟期,可见到边缘环形强化和壁结节的强化.也有1例见到分隔.结论:CT和MR均可显示肝脏囊性转移瘤的特征,MR在显示病灶的出血、囊变、分隔和囊壁的情况等比CT更为敏感、可靠,在鉴别诊断方面价值更大.

Comparison between CT and MR Manifestations of the Cystic Hepatic Metastatic Tumor

To analyze the CT and MR manifestations of the hepatic cystic metastatic tumor,compare the clinical diagnostic value for the cystic metastatic tumor by CT and MR.Materials and Methods:Among18cases of hepatic cystic metastatic tumor(altogether52lesions),10cases were performed by plain CT and portal venous contrast CT scanning,8cases were performed by MR T 1 -weighted and FMPSPGR multiphase dynamic contrast-enhanced scanning,observed the tumor's dimension,shape,number and the enhancement pattern of the cyst wall and wall nodule.Results:In2cases the lesion was single,in other16cases the lesions were multiple.The lesions were round-like or oval-like.The cyst walls were seen thickened irregularly on CT in8cases,among them the wall nodule protruded to the cyst cavity in6cases,septum in the cavity was seen in1case.The lesions had equally thin wall and thus misdiagnosed as hepatic cyst in2cases.On T 1 -weighted imaging,7cases showed low signals,1case showed mixed signal.On T 2 -weighted imaging,the lesions all had obvious high signals,2cases showed even signals,6cases showed uneven signals and the wall nodules were seen as slightly low signals.All lesions had no enhancement on arterial contrast phase,rim-like enhancement and nodule enhancement were seen on portal venous and delayed phase.The septum was also seen in1case.Conclusion:CT and MR both could show the features of the hepatic metastatic tumor.Compared to CT,MR was more sen-sitive and reliable in showing bleeding,cystic changes,septum and cyst wall of the lesion,it was more valuable in the differential diagnosis.