肝脏孤立性坏死结节的CT、MRI表现与病理对照研究

目的:探讨肝脏孤立性坏死结节(SNN)的CT、MRI表现及其分型诊断价值和病理基础.方法:分析经临床和病理证实的肝孤立性坏死结节29例(所有病例均行MR检查,其中15例行CT检查),探讨SNN的CT、MRI表现及其分型诊断价值和病理基础.结果:①单纯凝固性坏死型(14例),T1WI、T2WI上均呈低或低-等信号,增强扫描病灶内凝固性坏死无强化,周围包膜呈延迟强化.其中8例行CT检查,CT平扫呈低或等密度,增强扫描无强化,5例可见包膜呈延迟期环形强化.②伴液化性坏死型(5例),T1WI上呈低信号,较大病灶内可见更低信号；T2WI上病灶呈低-等信号,其内液化性坏死呈点片状更高信号；增强后病灶无强化,周围包膜呈轻-中度强化.CT检查3例,CT平扫呈低或等密度,增强扫描无强化,2例周围包膜呈延迟期环形强化.CT不能反映病灶内液化性坏死.③多结节融合型(10例),T1WI呈低信号,其内可见低-等信号分隔；T2WI病灶以等-稍高信号为主,其内可见等或略高信号分隔,其中6例合并液化性坏死还可见裂隙状高信号.增强扫描病灶无强化,其内分隔及周围包膜呈轻-中度强化.CT检查4例,其中3例为低或等密度融合结节,增强扫描内部分隔及周围包膜呈延迟期强化.CT不能显示内部液化性坏死和病灶全部分隔.结论:CT、MRI能较好反映肝脏孤立性坏死结节的分型及各型的病理特征,MRI在多结节融合型和伴液化坏死型的诊断价值明显优于CT.

Solitary Necrotic Nodule of the Liver: CT and MRI Manifestation and Correlation with Pathologic Findings

Purpose:To analyze the classification,CT and MR manifestation,and the pathological basis of solitary necrotic nodule of the liver(SNN),in order to evaluate CT and MRI as a diagnostic tool.Methods:Twenty-nine cases with pathologically proved SNN were analyzed and correlated with the classification and its pathological appearances.All 29 cases were undergone MR scans and 15 cases of them were undergone CT scans.Results:(1) Simple coagulation necrosis type(14 cases):These lesions showed hypo-or iso-intensity b...