摘要
目的:探讨肝硬化患者肝内融合状纤维化(CHF)的影像表现,并初步分析其发病原因。方法:回顾性分析2014-2021年在本院经病理确诊的6例CHF患者的MRI和CT资料,分析病灶的影像学征象,主要包括位置、密度/信号、形态、强化程度以及动态变化,并初步分析致病原因。结果:6例均行MRI扫描,其中4例病灶位于肝脏右前叶、方叶及左叶外侧段,1例以肝门为中心累及肝左叶和肝右叶,1例位于肝右后叶和左叶外侧段;病灶均呈片状稍长T_(1)、稍长T_(2)信号,DWI上较周围肝实质的信号稍高;动态增强扫描动脉期病灶无明显强化,门静脉期呈轻度强化,延迟期病灶进一步强化,延迟5 min后呈中度均匀强化,局部肝脏包膜呈不同程度局限性凹陷。3例行CT扫描,显示病灶呈大片状低密度区,病灶位置、形态、动态增强表现与MRI表现基本一致。4例病理确诊自身免疫性肝炎(AIH),1例长期服用不明中药史,1例患者致病原因不明。结论:CHF具有相对特征性的CT和MRI表现,AIH是否为国内中老年女性最常见致病因素值得进一步研究。
Objective:To investigate the imaging manifestations of confluent hepatic fibrosis(CHF)and to analyze the cause of CHF.Methods:MRI and CT manifestations of 6 patients with pa-thologically-proved CHF were analyzed,focused on the lesion,location,density or signal,morphology,enhancement and dynamic changes,and then the cause of CHF was analyzed.Results:Of the 6 patients,CHF was found in the right anterior lobe,quadrate lobe and left lateral lobe in 4 cases,in the right lobe and left lobe around porta hepatis in one case,and in right posterior lobe and left lateral external lobe in one case.Six patients underwent MRI examination.All lesions were hypo-intense on T_(1)WI with capsule retraction and were hyper-intense on T_(2)WI and on DWI.On the dynamic contrast enhanced MR images,all lesions were seen as slightly hypo-intense compared with normal liver parenchyma in the early dynamic phase,and presented as hyper-intense during the late phases.Three cases were examined by CT scan.The lesions were of low attenuation.Four patients were diagnosed autoimmune hepatitis(AIH),one patient had taken unknown drugs,one patient's etiology was unknown.Conclusion:The MRI and CT features of confluent hepatic fibrosis(CHF)are of some characteristics,Whether AIH is the common etiology among elder women in China is worth further research.
作者
朱杏莉
范乃军
邢予
张伯英
程秋波
ZHU Xing-li;FAN Nai-jun;XINGYu(MRI Room,the 989th Hospital of PLA,Henan 471031,China)
出处
《放射学实践》
CSCD
北大核心
2021年第12期1553-1557,共5页
Radiologic Practice
关键词
肝硬化
融合状纤维化
自身免疫性肝炎
磁共振成像
体层摄影术
X线计算机
Liver cirrhosis
Confluent hepatic fibrosis
Autoimmune hepatitis
Magnetic resonance imaging
Tomography,X-ray computed
