MRI Findings of Hepatic Granuloma in 12 Cases
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摘要: 目的: 探讨肝脏肉芽肿的MRI表现,提高对本病诊断的准确性。 方法: 对天津医科大学附属肿瘤医院2004年4月～2007年10月经手术病理证实的12例肝脏肉芽肿进行回顾性分析,其中肝脏结核7例,肝脏肺吸虫病2例,特发性肉芽肿3例。全部病例均行上腹MRI检查,序列包括T1WI、T2WI、动态增强MRI(DCE-MRI)和弥散加权(DWI)。 结果: 12例肝脏肉芽肿共13个病灶,其中4个为肉芽肿中早期病灶,9个为纤维化期病灶。1)肉芽肿中早期病灶T1WI呈低信号,T2WI呈较高信号,边界模糊,DCE-MRI于动脉期呈不均匀环形强化,门静脉期及延迟期强化程度逐渐增加,DWI呈稍高信号,ADC值为(1.347±0.379)×10-3(mm2/s),ADC比率为1.103±0.165.2)纤维化期病灶T1WI呈低信号,T2WI呈等信号,边界清楚,DCE-MRI无明显强化或仅边缘线样强化,DWI呈稍高信号,ADC值为(1.382±0.398)×10-3(mm2/s),ADC比率为0.978±0.116。 结论: 肝脏肉芽肿的MRI信号表现能反映其所处的病理时期,并可以与肝脏其它肿物鉴别,因而MRI在肝脏肉芽肿诊断中具有较高价值。Abstract: Objective: To investigate the MRI features of hepatic granuloma. Methods: Data from 12 cases of granuloma (7 cases of tuberculosis, 2 cases of paragonimiasis, and 3 cases of idiopathic granuloma) proved by surgery and pathology were retro-spectively analyzed.All of the patients underwent T1WI, T2WI, dynamic contrast-enhanced MRI (DCE-MRI), and diffu-sion weighted imaging (DWI). Results: A total of 13 lesions were found in these cases, including 4 lesions at the early and middle stages of granuloma and 9 lesions at the fibrosis stage.The lesions at the early and middle stages were hypointense on T1WI, hyperintense on T2WI, with an ill-defined margin.These lesions showed inhomogeneous circular enhancement in the arterial phase of DCE-MRI and then gradually went to increase in the portal and delayed phase.These lesions were slightly hyperintense on DWI, with an average ADC value of (1.347± 0.379)× 10 -3 mm 2/s and an ADC ratio of 1.103± 0.165.The lesions at the fibrosis stage were hypointense on T1WI, isointense on T2WI, with a well-defined margin.These lesions showed only slight enhancement or no enhancement in DCE-MRI.These lesions showed hyperintense on DWI, with an average ADC value of (1.382± 0.398)× 10 -3 mm 2/s and an ADC ratio of 0.978± 0.116. Conclusion: The MRI findings may re-flect different stages of hepatic granuloma and are helpful to differentiate it from other liver focal lesions.
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Keywords:
- Liver /
- Magnetic resounance imaging
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[1] 1 Sherlock S.Diseases of the liver and biliary system, 8th ed[M].London: Blackwell Scientific Publications, 1985.633-635.
2 孙宏训, 主编.肝脏病学 [M].江苏: 江苏科学技术出版社,1990,634.3 Satti MB, al-Freihi H, Ibrahim EM, et al.Hepatic granuloma in Saudi Arabia: a clinicopathological study of 59 cases [J].Am J Gastroenterol, 1990,85(6):669-674.
4 Sartin JS, Walker RC.Granulomatous hepatitis: a retrospective review of 88 cases at the Mayo Clinic [J].Mayo Clin Proc, 1991, 66(9): 914-918.
5 McCluggage WG, Sloan JM.Hepatic granulomas in Northern Ireland: a thirteen year review [J].Histopathology, 1994, 25(3): 219-228.
6 Gaya DR, Thorburn D, Oien KA, et al.Hepatic granulomas: a 10 year single centre experience [J].J Clin Patho1, 2003, 56(11): 850-853.
7 何德华, 詹镕洲, 主编.肝胆病理学 [M].上海: 第二军医大学出版社, 1997.243.
8 陈忠年, 沈铭昌, 郭慕依, 主编.实用外科病理学 [M].上海: 上海医科 大学出版社,1997.388.
9 Balci NC, Tunaci A, Akinci A, et al.Granulomatous hepatitis: MRI findings [J].Magn Reson Imaging, 2001,19(8):1107-1111.
10 Kawamori Y.Matsui O.Kitagawa K.et al.Macronodular tuber-culoma of the liver: CT and MR findings [J].AJR Am J Roentgenol, 1992,158: 311-313.
11 叶慧义, 高元桂, 董宝玮, 等.肝脏肺吸虫病变综合影像特征与病理 对照分析 [J].中华放射学杂志,1997,31(12):822-824.
12 Taouli B, Vilgrain V, Dumont E, et al.Evaluation of liver diffu-sion isotropy and characterization of focal hepatic lesion with two single shot echo-planar MR imaging sequences: prospective study in 66 patients[J].Radiology, 2003, 226(1): 71-78.
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