肝脏黏液性囊性肿瘤CT和MRI表现

目的探讨肝脏黏液性囊性肿瘤(Mucinous Cystic Neoplasm,MCN)影像学表现。方法回顾性分析8例经病理证实的肝脏黏液性囊性肿瘤(MCN)CT和MRI表现及临床资料,总结其影像特征,2例行CT检查,6例行MRI检查。由2位腹部放射诊断医生共同阅片观察影像学特点。结果 8例MCN均为女性,年龄25-79岁,均为单发多囊,肝左内叶2例,左叶3例,左右叶交界区1例,右叶2例,病灶体积均较大,最大直径3.5cm-23.0cm不等。2例CT平扫表现为较大或巨大低密度,多房囊性病变,囊内可见线状分隔,囊壁均匀,壁薄、光滑;6例MRI检查,平扫均为多房囊性占位,T1WI为低信号,T2WI为高信号,且大囊边缘分布多发小囊,大小囊信号有差异,囊内分隔呈低信号,其中1例伴囊内出血,见液液平面;动态增强CT/MRI示:动脉期囊壁及分隔轻度强化,门脉期及延迟期持续强化。结论肝脏黏液性囊性肿瘤肝左叶多见,中年女性多见,在CT和MRI表现上具有一定特征性,肝内较大或巨大囊性病灶,呈多囊状(大囊伴多个小囊),囊壁均匀、壁光滑伴其内线状分隔,以及囊壁及分隔的强化方式,可为该病的鉴别诊治提供帮助。

CT and MRI Findings of Mucinous Cystic Neoplasm(MCN) of the Liver

Objective To investigate the CT and MRI appearances of mucinous cystic neoplasm (MCN).Methods CT and MRI findings and clinical data of 8 patients with liver MCN confirmed by pathology were analyzed retrospectively. Two patients underwent CT, and 6 underwent MRI. Imaging morphologic features of tumors were retrospectively reviewed by two abdominal radiologists.Results Eight cases of MCN are women with age of 25-79 and the lesions are all single polycystic. Two lesions were in left internal lobe of liver, 3 cases in left lobe, 1 in junction region of left and right lobe and 2 in right lobe. The lesions were bigger volume with a diameter from 3.5 cm to 23.0 cm. The CT images of 2 cases show like large multilocular cystic lesion with low density in which the line separation can be seen. The cystic wall was uniform, thin and smooth; MRI scan of 6 cases presented as all multiple cystic lesion with low signal in T1WI and high signal in T2WI, and multiple follicles were distributed along the capsule marginal, the signal was different among the different size of cystic lesion. The linear separation was low signal. One case had capsule hemorrhage and liquid-liquid plane. Dynamic enhanced CT/MRI: Capsule wall and the separation had mild arterial enhancement and they continued to strengthen in portal phase and delay.Conclusion Mucinous cystic neoplasm found in the left hepatic lobe, seen more at midlife women, It has a certain characteristic on CT and MRI performance like polycystic shaped (big capsule with multiple pockets), uniform and smooth cystic wall with its linear space, and its way of strengthening,which can help differential diagnosis and treatment of the disease.