摘要
目的 探讨肝脏炎性肌纤维母细胞瘤(HIMT)的MRI、CT表现与病理对照.方法 回顾性分析20例经病理证实为肝IMT的临床资料、CT及MRI表现,讨论并总结肝IMT的影像学表现及病理特点.结果 20例镜下均表现为不同程度的凝固性坏死、纤维组织增生及炎症细胞浸润.11例位于肝右叶,9例位于肝左叶,其中13例位于肝边缘或包膜下.16例CT平扫表现为稍低密度,1例呈等密度.T1WI 13例呈低或稍低信号,1例呈等信号,T2WI 14例均呈高或稍高信号.其中4例中央可见小结节状异常信号,相对于病灶主体在T1WI上呈更低信号,T2WI上呈更高信号,11例DWI上呈高或稍高信号,2例DWI上呈等信号.三期增强扫描:20例均表现为延迟性强化,15例呈环状强化;3例呈分隔样强化,3例呈全瘤样强化,4例可见"厚壁圆环中心点"征,4例见门静脉漂浮征.结论 肝IMT多发生于肝包膜下或肝边缘,增强扫描多呈延迟性强化,门脉期及延迟期环状强化、门静脉漂浮征具有一定特征性,对肝IMT的诊断及鉴别诊断具有一定意义.
Abstract
Objective To investigate CT and MRI manifestations and pathologic correlation of hepatic inflammatory myofibroblastic tumor.Methods The imaging and clinical material with pathologically proven HIMT of 20 cases were reviewed retrospectively.The imaging and pathological characteristics of HIMT were analysed.Results 20 cases showed different degrees of organized necrosis,fibrous tissue and inflammatory cells infiltration pathologically.11 cases located on right lobe of the liver and 9 cases on the left lobe.13 cases located on the edge of liver or under hepatic capsule.16 cases showed low density on pre-contrast CT and 1 case showed isodensity.On T1WI,13 cases showed hypointense or slight hypointense and 1 case showed isointense.All cases showed hyperintensity or slight hyperintensity on T2WI.11 cases showed hyperintensity or slight hyperintensity on DWI.4 cases had lowerT1WI and higher T2WI in their center.20 cases all showed delayed enhancement in portal and delayed phase.The manifestations of enhancement were diverse in portal and delayed phase:ring-like enhancement(15 cases),septal enhancement(3 cases),entire enhancement(3 cases),Thick-torus-wall & Central-dot sign(4 cases),"portal vein floating"sign(4 cases).Conclusion HIMT often occurs on the edge of liver or under hepatic capsule.HIMT usually shows delayed enhancement on post-contrast phase.Ring-like enhancement and portal vein floating"sign contribute to the diagnosis and differential diagnosis of HIMT.
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