摘要
目的比较超声与磁共振成像(magnetic resonance imaging,MRI)对肝脏多发性局灶性结节性增生(focal nodular hyperplasia,FNH)病变的诊断价值。方法 21例患者均经手术或活检病理检查,在术前均行多次MRI检查与超声检查。腹部平扫与扎钡葡胺(Gd-BOPTA)多时相动态增强扫描采用1.5T超导MRI扫描仪进行MRI检查。采用GE公司配有编码相位反转技术的logic9彩色超声显像仪进行超声检查。结果 MRI检查显示:2例肝内门静脉缺如;与邻近肝脏相比,多发FNH实质部分注射Gd-BOPTA后,动脉期显著均匀强化病灶35个,不均匀强化病灶22个,无强化1个;门静脉期和延迟期28个病灶呈稍高信号,20个病灶呈等信号,7个病灶呈稍低信号,增强曲线呈"快进慢出"型。8个病灶中心出现T1WI低信号,T2WI高信号;门静脉期与延迟期轻至中度逐渐增强,动脉期未见增强。2例肝门区见肝总动脉增粗迂曲,肝右叶与门静脉分支相交通。超声表现:FNH 21例,动脉相100%高增强,19.0%的患者从中心向周边强化范围逐渐扩大,71.4%早期动脉相从中心至周边"星形"或"轮辐样"动脉强化,9.5%的患者未观察到上述特征性征象,表现为病灶整体弥漫性高增强;100%门脉性高增强;延迟相有85.7%呈等或略高增强,14.3%中心部造影剂退出呈低增强。结论 MRI检查对多发性FNH的确诊更有临床意义,超声造影可用于不典型的多发性FNH,有助于鉴别诊断。
Objective To compare the diagnostic value of ultrasound and magnetic resonance imaging（ MRI） for multiple focal nodular hyperplasia（ FNH） of the liver lesions. Methods Twenty-one patients were confirmed by surgery or biopsy,and underwent preoperative MRI and ultrasound examination times. GE 1. 5T superconducting MRI scanners scan and tie barium dimeglumine（ Gd-BOPTA） temporal dynamic enhanced scan were used for MRI examination. GE company logic 9 color ultrasound imaging device,with a coded phase inversion,was used for ultrasound examination. The dynamic image was analyzed by two experienced sonographer,lesion enhancement was observed at different time characteristics. Results The results of MRI showed that 2 cases absence of intrahepatic portal vein; compared with neighboring liver,multiple FNH substantial part of Gd-BOPTA after injection,35 arterial lesions were significantly enhanced uniform 22 lesions were heterogeneous enhancement,1 lesion was no enhancement; portal venous phase and delay of 28 lesions were slightly higher signal,7 lesions were slightly lower signal,20 lesions showed equal signal enhancement,curve was ＂fast and slow-out＂type. Eight lesion centers showed low signal with T1 WI and high signal with T2W1; arterial phase and delayed phase from strengthened gradually mild to moderate,arterial phase showed no enhancement. Two cases of hilar showed tortuous hepatic artery thickening,the right lobe with portal vein phase transport.Ultrasonography showed 21 patients with FNH,100% of the high enhancement in the arterial phase,19. 0% of patients gradually expanded from the center to the periphery enhanced range,71. 4% early arterial phase ＂star＂or ＂spoke-like＂from the center to the peripheral arterial enhanced. There was no characteristic signs of the above observed in 9. 5% of the patients,the performance of the overall diffuse high-enhancing lesions; portal of 100% high enhancements; delayed phase 85. 7% showed equal or slightly increased,the central portion of the contrast agent exits were 14. 3% lower enhancement. Conclusion MRI examination in the diagnosis of multiple FNH has more clinical significance,and ultrasound imaging can be used in atypical multiple FNH,contribute to the differential diagnosis.
出处
《胃肠病学和肝病学杂志》
CAS
2015年第7期840-843,共4页
Chinese Journal of Gastroenterology and Hepatology
关键词
超声造影
磁共振成像
肝脏
多发性局灶性结节性增生
Ultrasound contrast
Magnetic resonance imaging
Liver
Multiple focal nodular hyperplasia
