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肝硬化患者出血后多发再生结节梗死的CT和MRI表现

徐晓莉 张涛 张学琴

徐晓莉, 张涛, 张学琴. 肝硬化患者出血后多发再生结节梗死的CT和MRI表现[J]. CT理论与应用研究, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.063
引用本文: 徐晓莉, 张涛, 张学琴. 肝硬化患者出血后多发再生结节梗死的CT和MRI表现[J]. CT理论与应用研究, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.063
XU X L, ZHANG T, ZHANG X Q. CT and MRI Findings of Multiple Infarcted Regenerative Nodules in Liver Cirrhosis after Variceal Hemorrhage[J]. CT Theory and Applications, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.063. (in Chinese)
Citation: XU X L, ZHANG T, ZHANG X Q. CT and MRI Findings of Multiple Infarcted Regenerative Nodules in Liver Cirrhosis after Variceal Hemorrhage[J]. CT Theory and Applications, 2022, 32(0): 1-6. DOI: 10.15953/j.ctta.2022.063. (in Chinese)

肝硬化患者出血后多发再生结节梗死的CT和MRI表现

doi: 10.15953/j.ctta.2022.063
详细信息
    作者简介:

    徐晓莉:女,影像医学与核医学专业硕士,南通大学附属南通第三医院影像科主治医师,主要从事腹部影像诊断,E-mail:330703739@qq.com

    张涛:男,南通大学附属南通第三医院影像科主任医师,南通大学硕士生导师,主要从事腹部影像诊断,E-mail:19931067@qq.com

    通讯作者:

    张涛*,

  • 中图分类号: R  814;R  445

CT and MRI Findings of Multiple Infarcted Regenerative Nodules in Liver Cirrhosis after Variceal Hemorrhage

  • 摘要: 目的:探讨肝硬化患者静脉曲张出血后多发再生结节梗死的CT和MRI表现。方法:共收集21例诊断为肝硬化患者静脉曲张出血后多发再生结节梗死的患者纳入本研究,其中男13例,女8例,检查采用3.0T MR扫描仪或256排螺旋CT,所有病例均行动态增强扫描,分析病变的强化模式、信号强度、形状、数量、大小、边缘、位置和分布。结果:在CT或MRI成像中,3例患者病灶在10个及以下,19例患者病灶在10个以上;肝脏病灶直径3~26 mm;大部分病灶为圆形结节、呈簇状聚集分布;病灶主要分布于肝包膜下区域;CT和MRI动态增强后,大部分结节未见明显强化;少数可以有边缘强化;在T1WI所有病灶呈等信号或稍低信号;在T2WI大部分病变为边界限清晰的高信号;CT和MRI随访13例患者病灶消失,8例患者病灶缩小或明显减少。结论:CT和MRI可显示肝硬化静脉曲张出血后再生结节梗死的影像特征,通过影像随访、临床病史、肿瘤指标可与肝脏恶性肿瘤相鉴别。

     

  • 图  1  女,67岁,乙肝肝硬化患者30余年,消化道出血14 h

    (a)~(d)分别是CT平扫、动脉期、门脉期、延迟期,图像显示肝内多发小结节状、类圆形低密度灶,呈簇状分布,多位于肝包膜下,直径约5~13 mm,增强后大部分病灶未见明显强化,少部分边缘轻度强化。

    Figure  1.  Female, 67 years old, Hepatitis B cirrhosis patients more than 30 years, the gastrointestinal bleeding was admitted within 14 h

    图  2  男,46岁,乙肝肝硬化患者10余年,上消化道出血16 h

    (a)~(d)分别是CT平扫、动脉期、门脉期、延迟期示肝内多发小结节状、类圆形低密度灶,呈簇状分布,多位于肝包膜下,直径约10 mm,增强后病灶未见明显强化、呈低密度。(e)~(h)为该患者入院后4天行MRI检查,(e)为T2WI示肝内多发小结节状类圆形高信号灶,(f)为DWI示病灶呈稍高信号,(g)为T1WI平扫示病灶呈稍低信号,(h)为增强后门脉期示病灶未见强化呈低信号。

    Figure  2.  Male, 46 years old, Hepatitis B cirrhosis patients more than 10 years, the gastrointestinal bleeding was admitted within 16 h

    图  3  为图1同一患者MRI检查

    (a)和(b)为T2 WI、DWI显示肝内多发小结节状、类圆形高信号灶,呈簇状分布,多位于肝包膜下。(c)和(d)为该患者一年后随访复查,肝内病灶全部消失。

    Figure  3.  MRI examination of the same patient in figure 1

    表  1  患者的临床基本资料

    Table  1.   The basic clinical data of patients

    类别结果
     男性︰女性 13︰8
     平均年龄/岁 57±7.23
     肝硬化原因(乙型肝炎︰丙型肝炎︰酒精性) 17︰1︰3
     肝癌史(有︰无) 3︰18
     肝功能(正常︰升高) 0︰21
     肿瘤标志物(正常︰升高) 21︰0
    下载: 导出CSV

    表  2  结节特征

    Table  2.   Characteristics of nodules

    类别结果
        结节形状(圆形︰不规则形)88.8%︰12.2%
        结节数目(≤10︰11~30︰31~50︰>50)3︰8︰7︰3
        结节大小(≤0.5 cm︰0.6~1.0 cm︰1.1~2.0 cm︰≥2.1 cm)22.5%︰51.3%︰25.8%︰0.4%
        边缘(清楚:不清)15︰6
        位置(肝包膜下︰中心︰两者皆有)16︰1︰4
        分布(聚集:散发)18︰3
        强化方式(无强化︰边缘轻度强化)80.6%︰19.4%
        CT平扫等密度或稍低密度
        T1WI信号等信号或稍低信号
        T2WI信号高信号
        DWI稍高信号或等信号
    下载: 导出CSV
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出版历程
  • 收稿日期:  2022-04-12
  • 录用日期:  2022-11-03
  • 网络出版日期:  2022-11-10

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