Departments of Radiology, Hepatic Surgery, and Pathology, Renji Hospital, Shanghai Jiaotong University School of Medicine, No. 1630 Dongfang Rd, Pudong, Shanghai 200127, P.R. China.
Radiographics. 2013 Sep-Oct;33(5):1419-33. doi: 10.1148/rg.335125063.
A multilocular cystic hepatic lesion detected at computed tomography (CT) and magnetic resonance (MR) imaging is a common but nonspecific radiologic finding that can cause potential challenges for differential diagnosis. This imaging pattern may be observed in a wide spectrum of common and uncommon neoplastic or nonneoplastic entities. Neoplastic lesions include cystadenoma, cystadenocarcinoma, hepatocellular carcinoma (HCC), metastases, mesenchymal hamartoma, and inflammatory myofibroblastic tumor. Nonneoplastic lesions include hepatic abscess, echinococcal cyst, intrahepatic hematoma, and biloma. The multiple coalescent cysts seen in polycystic liver disease may exhibit an imaging pattern similar to that of a multilocular cystic lesion. Mural nodularity, irregular thickness of the septa, ragged inner surface, and typical enhancement pattern in the solid portion of the lesion are often indicative of malignancy, although multilocular primary or secondary malignant tumors are uncommon. Recognition of the more common necrosis or cystic change of HCC and metastases induced by locoregional or systemic treatment also is important. The nonenhanced cystic component may be composed of different types of fluids (eg, serous, mucinous, proteinaceous, hemorrhagic, bilious, or mixed) or spontaneous or treatment-related necrosis, whereas the septa may be formed by a wide range of tissues depending on the lesion type. An understanding of the CT and MR imaging findings of these lesions and their respective pathologic correlation aids in accurate diagnosis.
在计算机断层扫描（CT）和磁共振（MR）成像中检测到的多房性囊性肝病变是一种常见但非特异性的放射学表现，可能对鉴别诊断造成潜在挑战。这种影像学模式可能在广泛的常见和罕见的肿瘤或非肿瘤实体中观察到。肿瘤病变包括囊腺瘤、囊腺癌、肝细胞癌（HCC）、转移瘤、间叶性错构瘤和炎症性肌纤维母细胞瘤。非肿瘤病变包括肝脓肿、包虫囊肿、肝内血肿和胆汁瘤。多囊肝病中所见的多个融合性囊肿可能表现出类似于多房性囊性病变的影像学模式。壁结节、分隔不规则增厚、粗糙的内表面以及病变实性部分的典型强化模式通常提示恶性肿瘤，尽管多房性原发性或继发性恶性肿瘤并不常见。认识到 HCC 和转移瘤的更常见的坏死或囊性改变，以及局部或全身治疗引起的坏死或囊性改变也很重要。无增强的囊性成分可能由不同类型的液体（例如浆液性、黏液性、蛋白性、血性、胆汁性或混合性）或自发性或治疗相关的坏死组成，而分隔可能由广泛的组织组成，具体取决于病变类型。了解这些病变的 CT 和 MR 成像表现及其相应的病理相关性有助于准确诊断。
