Department of Radiology, The First People's Hospital of Shunde, Foshan, Guangdong, People's Republic of China.
Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, People's Republic of China.
Abdom Radiol (NY). 2017 Dec;42(12):2874-2881. doi: 10.1007/s00261-017-1230-4.
To investigate the findings of computed tomography (CT) and magnetic resonance imaging (MRI) of focal eosinophilic infiltration (FEI) of the liver.
A retrospective study including 29 patients with confirmed FEI of the liver was performed. We evaluated the lesions' number, distribution, size, shape, margin, attenuation or signal intensity characteristics, the enhancement pattern, and some special features. Spearman correlation analysis was used to analyze the correlation between the number of lesions and the eosinophil counts in peripheral blood.
In all, 108 lesions were detected in 29 cases, including two cases with single lesion and the remaining 27 cases with multiple lesions. The mean size of all lesions was 34 mm (range, from 3 to 61 mm). 95 (88%) lesions were located in subcapsular parenchyma or surrounding the portal vein. Most (66%) subcapsular lesions were wedge shaped and all lesions surrounding portal vein were round shaped. However, the hepatic parenchymal lesions were irregular or round shaped. All lesions showed ill-defined margins. On pre-contrast CT images, the lesions showed slightly low attenuation or iso-attenuating. On T1-weighted and T2-weighted images, the lesions were slightly iso-/hypointense and hyperintense, respectively. A total of 23 (79.3%) cases were gradually enhanced. Branches of portal vein went through the lesions in all cases; 12 had 'stripe sign' and 16 had 'halo ring sign.' Spearman analysis indicated a significant correlation between the number of lesions and the increased eosinophils in peripheral blood (r = 0.627, p = 0.0003).
Special CT and MRI features and increased eosinophils may strongly suggest the diagnosis of FEI of the liver.
探讨肝脏局灶性嗜酸性粒细胞浸润(FEI)的计算机断层扫描(CT)和磁共振成像(MRI)表现。
对 29 例经病理证实的肝脏 FEI 患者进行回顾性研究。我们评估了病变的数量、分布、大小、形状、边缘、衰减或信号强度特征、强化模式以及一些特殊特征。采用 Spearman 相关分析评估病变数量与外周血嗜酸性粒细胞计数之间的相关性。
共发现 29 例患者的 108 个病变,包括 2 例单发,27 例多发。所有病变的平均直径为 34mm(范围 3~61mm)。95 个(88%)病变位于肝包膜下实质或门静脉周围。大多数(66%)包膜下病变呈楔形,所有门静脉周围病变均呈圆形。然而,肝实质病变呈不规则或圆形。所有病变的边界均不清楚。平扫 CT 图像上,病变呈轻度低衰减或等密度。T1 加权和 T2 加权图像上,病变分别呈轻度等/低信号和高信号。23 例(79.3%)呈渐进性强化。所有病例门静脉分支均穿过病变,12 例有“条纹征”,16 例有“晕环征”。Spearman 分析表明,病变数量与外周血嗜酸性粒细胞增多呈显著正相关(r=0.627,p=0.0003)。
特殊的 CT 和 MRI 特征以及外周血嗜酸性粒细胞增多强烈提示肝脏 FEI 的诊断。