MRI诊断肝脏炎性假瘤

目的 :探讨MRI对肝脏炎性假瘤 (IPL)的诊断价值。材料和方法 :回顾性分析经病理证实的 16例IPL的MRI表现 ,并与病理所见对照。结果 :病理诊断前 13例诊断为良性病变 ,3例误诊为恶性肿瘤。T1WI低信号、T2WI高信号组 12例 :血管炎型 5例、浆细胞肉芽肿型 3例、坏死型 4例 ;T1WI和T2WI低信号组 2例 :坏死型和硬化型各 1例 ;T1WI和T2WI等信号、高信号各 1例均为血管炎型。 2例血管炎型于动脉期显著强化、门脉期和延迟期中度强化 ;3例血管炎型和 2例浆细胞肉芽肿型于动脉期轻度强化、门脉期和延迟期中度强化 ;3例坏死型于门脉期和延迟期周边轻度强化。结论 :IPL的MRI表现缺乏特异性。MRI能将多数IPL诊断为良性病变。

MR Imaging Findings of Inflammatory Pseudotumor of the Liver

Purpose: To evaluate the diagnostic value of MR imaging in inflammatory pseudotumor of the liver (IPL). Materials and Methods: The MR imaging features of 16 cases of IPLs proved by pathology were retrospectively reviewed and correlated with pathologic findings. Results: Thirteen cases were diagnosed as benign lesions and three cases mistaken for malignant tumors. Five vasculitis types of IPL, three plasma cell granulomatous types of IPL, and four necrotic types of IPL were hypointense on T1WI and hyperintense on T2WI. One sclerotic type of IPL and one necrotic type of IPL were hypointense on T1WI and T2WI. One vasculitis type of IPL was isointense on T1WI and T2WI, and one vasculitis type of IPL was hyperintense on T1WI and T2WI. Two vasculitis types of IPL showed strong enhancement during arterial phase, and moderate enhancement during portal venous phase and delayed phase. Three vasculitis types of IPLs and two plasma cell granulomatous types of IPL showed slight enhancement during arterial phase, and moderate enhancement during portal venous and delayed phase. Slight peripheral enhancement during portal venous and delayed phase was detected in three necrotic types of IPL. Conclusion: The MR imaging findings of IPL were nonspecific and it is possible that most of IPL can be diagnosed as benign lesions.