Iwase Kazuhiro, Higaki Jun, Yoon Hyung-Eun, Mikata Shoki, Miyazaki Minoru, Torikai Kei, Shirai Yasuhiro, Awai Kazuo, Imakita Masami, Kamiike Wataru
Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, 2-23, Rinku Orai-Kita, Izumisano, Osaka 598-8577, Japan.
J Hepatobiliary Pancreat Surg. 2002;9(1):120-4. doi: 10.1007/s005340200014.
Solitary necrotic nodule of the liver is a rare benign lesion; only 22 cases have been reported to date. An unsolved problem in treating these lesions involves the difficulties in differential diagnosis; specific features of necrotic nodule of the liver in preoperative examinations have not been identified. Here, we report a patient with resected solitary necrotic nodule of the liver with preoperative features shown on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) examinations. A 48-year-old woman was referred to our hospital on December 13, 1999 because a hypoechoic lesion in Couinaud's segment VIII of the liver had been incidentally detected on US. A CT scan confirmed the presence of a round hypodense lesion, measuring 2 cm in diameter. No significant enhancement was recognized on dynamic MRI study. T1-Weighted MRI examinations demonstrated a low intensity showing a triple-layered pattern with low-iso-low intensity in the lesion, while T2-weighted images demonstrated a slightly high intensity in the lesion. These features suggested fibrous tissue. Histological examinations following partial resection of the liver revealed a solitary necrotic nodule of the liver. Combination studies, including MRI examinations, would be useful for the preoperative diagnosis of a solitary necrotic nodule of the liver.
肝脏孤立性坏死结节是一种罕见的良性病变;迄今为止仅报道过22例。治疗这些病变时一个尚未解决的问题在于鉴别诊断存在困难;术前检查中肝脏坏死结节的特异性特征尚未明确。在此,我们报告一例肝脏孤立性坏死结节切除患者,其术前特征通过超声(US)、计算机断层扫描(CT)和磁共振成像(MRI)检查得以显示。一名48岁女性于1999年12月13日因超声偶然发现肝脏Couinaud VIII段有一低回声病变而转诊至我院。CT扫描证实存在一个直径2 cm的圆形低密度病变。动态MRI检查未发现明显强化。T1加权MRI检查显示病变呈低强度,呈现低-等-低强度的三层模式,而T2加权图像显示病变呈轻度高强度。这些特征提示为纤维组织。肝脏部分切除后的组织学检查显示为肝脏孤立性坏死结节。包括MRI检查在内的联合检查对于肝脏孤立性坏死结节的术前诊断可能有用。