肝脏多房环形强化病变的影像分析?

目的：分析肝脏多房环形强化的影像学特征，探讨肝脓肿、肝内胆管细胞癌、肝转移瘤的鉴别诊断要点。方法：回顾性分析31例肝脏病变表现为多房环形强化的影像学特征，其中肝脓肿15例，肝内胆管细胞癌7例，肝转移瘤9例。13例行上腹部 CT 平扫和三期增强检查，7例行 MRI 平扫及 LAVA 多期增强检查，11例同时行 CT 和 MRI 检查。结果：3种病变在环壁及分隔的强化征象有差异。肝脓肿环壁及分隔均匀、完整（P <0.05），可见病灶缩小征（P <0.05）。胆管细胞癌环形强化呈向心性充填（P <0.05），或出现肝包膜回缩（P <0.05）和扩张胆管壁的局限性增厚。环壁不规则中断或见强化的壁结节，是诊断转移瘤较有价值的征象。结论：肝脓肿、肝内胆管细胞癌、肝转移瘤 3种病变各有其影像特点，CT 及 MR 检查对三者的诊断与鉴别诊断有重要价值。

Analysis of Imaging Findings of Hepatic Multi-locular Ring-enhancement Lesions

Objective: To study manifestations of hepatic multilocular and ring-enhancement lesions and differential diagnosis of liver abscess, intrahepatic cholangiocarcinoma and liver metastasis. Methods: Imaging findings of 31 cases were retrospectively analyzed, including liver abscess 15cases, intrahepatic cholangiocarcinoma 7 cases and liver metastasis 9 cases. 13 cases carry the CT plain scan and three phases enhanced examination of upper abdominal. 7 cases underwent MRI plain scan and LAVA multiphase scanning. 11 patients underwent CT and MRI examination meanwhile. Results: There was a statistical difference among the three multilocular and ring-enhancement lesions for the enhancement signs of the morphology of ring wall and septum. The ring-wall and septum thickness uniformity, complete enhancement (P < 0.05), and the appears mass diminution sign (P < 0.05).The ring enhancement in a centripetal filling (P < 0.05) or retraction of liver capsule (P < 0.05) and expansion of bile duct wall local thickening, the findings is helpful to diagnosis cholangiocarcinoma. The ring-wall irregular interrupt or enhancing wall nodule, it has great value for diagnosis for liver metastasis. Conclusions: The three lesions have their imaging features, combine with CT and MRI have a high value for differentia diagnosis of the three lesions.