肝脓肿临床与MRI诊断

目的：分析肝脓肿的临床及M RI表现，旨在提高其诊断准确性。方法：回顾性分析经皮肝穿刺和手术后病理证实以及临床治疗后显著疗效的24例肝脓肿临床及M RI影像表现的特点。结果：24例肝脓肿单发病变5例，呈圆形、类圆形，多发性病变19例，呈大小不等的类圆形或圆形。病变呈长 T 1、长 T 2信号区，其信号不均匀。病灶中心区域可见更长T1、更长T2信号。病灶周围的肝组织内可见云雾状稍长T1、稍长T2信号。动态增强在动脉期肝脓肿边缘即有轻微的强化，此时周边肝组织有明显强化，静脉期和延迟期强化程度与正常肝组织强化程度相同，脓肿的壁呈明显的环行强化，壁薄而规则，中心区域无明显强化。多发病灶呈多房状或蜂窝状，在动脉期病灶内即有大小不等的圆形环状强化，病灶中的分隔强化明显，其周边的肝实质内可见明显的强化区域，静脉期和延迟期病灶边缘强化逐渐增强，但在病灶的中央部分无明显强化，病灶周边的肝组织内充血带与正常肝实质的强化趋向均匀一致。结论：M RI对肝脓肿的临床诊断具有重要价值和优越性。

MRI Diagnosis and Clinic of Hepatic Abscess

Objective ：To analyze the MRI and clinical appearance of hepatic abscess ,to improve its diagnostic level . Methods ：The MRI finding and clinical data in 24 cases proved by clinical or pathological or showing availability after treatment were analyzed retrospectively .Results：Of 24 cases ,single lesions 5 cases and multiple 14 cases ,were round shaped or round homoplastically .All lesions were hypointense on T1WI and hyperintense on T2WI ,the signal was het-erogeneous .The central of the lesions showed more hypointense and more hyperintense signal .The adjacent liver form showed nebulous hypointense and more hyperintense signal .In arterial phase of contrast-enhanced MRI scanning ,the edge of hepatic abscess showed light enhancement ,at the same time ,the adjacent liver form showed enhanced observ-ably .The walls of abscess showed ring-shaped enhancement ,the walls were thin and regular ,the central of abscess did not show enhancement .The multiple lesions were multilocular or alveolate ,that showed ring-shaped enhancement in arterial phase and the interval in the lesion showed marked enhancement ,the adjacent liver form showed marked en-hancement ,the edge of lesions was enhanced gradually in venous and delay phase ,but the center of lesions did not show enhancement .The adjacent congestive liver form showed the same degree enhancement as the regular liver tissue .Con-clusion：M RI is very important and ascendant in diagnosis of hepatic abscess .