肝脏不典型转移瘤CT及MRI的诊断与鉴别诊断

目的探讨肝脏不典型转移瘤的CT及MRI诊断价值。材料与方法回顾分析经临床随访或穿刺病理证实的肝脏不典型转移瘤12例,肝脏囊性转移瘤8例及血管瘤样转移瘤4例,均行CT或MRI多次随访检查,分析其病灶CT及MRI特点。结果本组转移灶均为多发病灶,边界清楚,原发病多样。肝囊性转移瘤及血管瘤样转移CT无特征性表现,MRI检查DWI(b=800)均呈高信号,多无灯泡征,莫迪司Gd-BOPTA动态增强延迟1h多无摄取,部分可见晕征或点征。结论 MRI检查在肝脏不典型转移瘤诊断及鉴别诊断价值优于CT,对有肝脏囊性或血管瘤样病灶的癌症患者要加以MRI密切随访复查。

The Value of CT and MRI in Diagnosing Atypical Liver Metastasis

Objective To evaluate the wllue of CT and MRI in diagnosing atypical liver metastasis. Materials and Methods 12 cases proven by pathology among which 8 are liver cystic metastase and 4 hemangioma-like metastase were analyzed retrospectively. Results All the metastases are well-defined multiple lesions with various protopathies. Cystic metastases and hemangiomalike metaslase have no characteristic features on CT scan, while DWI （b = 800） is high signal, with nearly no bulb sign and Gd-BOPTA dynamic enhancement delayed by I hour invisible intake. Halo sign and dot sign could be observed in some cases. Conclusion The value of diagnosis and differential diagnosis of atypical liver metastases by MRI scan is higher than that by CT scan and frequent MRI following-up becomes necessary for the patients with liver cystic metastasis or hemangioma-like metastasis.