肝脏炎性假瘤:13例MRI征象

目的 分析13例肝脏炎性假瘤（IPL）在MRSE序列和FMPSPGR序列动态增强扫描中的征象，以进一步提高对该病的诊断水平。资料与方法 13例经手术证实的IPL，术前均行MRI检查，行SE序列T1WI，FSE序列T2WI和FMPSPGR序列多其动态增强成像，统计病灶数目，观察病灶在各序列上的信号变化和强化特征。结果 共发现病灶15个，在SET1WI上，5个病灶为等信号，其余10个病灶为略低信号。在SET2WI上，5个病灶为略高信号，10个病灶为等信号。在SE序列上病灶的边界显示不清，动态增强扫描动脉期，15个病灶均无明显强化，在门脉期和/或延迟期，所有病灶可见到强化表现，如：（1）周边环形强化（12/15，80.0%)，（2）小结节状强化（6/15，40.0%)。位于边缘呈“钟乳石”状或位于中心呈核心状；（3）分隔强化（8/15，53.3%)。结论 MRSE序列对IPL的检出和定性有一定困难，FMSPGR多期动态增强可反映病灶的病理特征，提供有价值的鉴别诊断依据。

MRI Findings of Hepatic Inflammatory Pseudotumor: An Analysis of 13 Cases

Objective To analyze MRI features of inflammatory pseudotumor of the liver, and to improve its diagnostic accuracy.Materials and Methods Thirteen patients with surgically proved hepatic inflammatory pseudotumor were enrolled in this study, dynamic enhanced MRI, including SE T 1WI, FSE T 2WI and FMPSPGR, was performed preoperatively in all patients. The number of the lesions and the features of the signal and enhancement were observed, and a comparison with pathological results was made.Results A total of 15 lesions was found. On SE T 1WI, 10 lesions were slightly hypointense and 5 isointense. On SE T 2WI, 5 lesions were slightly hypointense and 10 isointense. On dynamic enhanced MRI, no obvious enhancement was seen during arterial phase in all lesions, while several patterns of enhancement were demonstrated during portal and/or delayed phase, including peripheral enhancement (12/15, 80%), nodular enhancement (6/15, 40%) and septal enhancement (8/15, 53.3%). Conclusion SE sequence has limitation in detecting hepatic inflammatory pseudotumor as well as in identifying the nature of the lesion. Multiphase dynamic enhanced FMPSPGR can reflect lesion's pathologic features, providing valuable information for the diagnosis and differentiation.