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局灶性肝紫癜的磁共振成像及弥散加权成像特征

[Magnetic resonance imaging and diffusion weighted imaging features of focal peliosis hepatis].

作者信息

Liu Z J, Yao J M, Wang M L, Geng T T, Dong G, Zeng M S

机构信息

Department of Radiology, Weifang People's Hospital, Weifang 261041, China.

Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2019 Feb 19;99(7):496-499. doi: 10.3760/cma.j.issn.0376-2491.2019.07.004.

Abstract

To investigate the MRI and diffusion weighted imaging (DWI) features of focal peliosis hepatis. The clinical data and MRI of 19 cases with focal peliosis hepatis confirmed by pathology from January 2012 to March 2018 in Zhongshan Hospital of Fudan University were retrospectively analyzed. The number, location, size, shape, signal intensity of plain scan of lesions, enhancement pattern of lesions, vessels within lesions, and perfusion disorders of hepatic parenchyma were analyzed. The apparent diffusion coefficient (ADC) values of the lesions and adjacent hepatic parenchyma were measured, then the differences between them were explored statistically. All 24 lesions were categorized into group A with tumor-related chemotherapy and group B without tumor-related chemotherapy. The differences of MR features between the two groups were explored statistically. In all 24 lesions, 22 lesions were located in the right lobe, 2 lesions in the left lobe. The median size was 7.5-72.0 (24.4±17.2) mm.On T(1)WI,21 lesions showed slightly hypointensity, 1 lesion showed slightly hyperintensity and 2 lesions were isointensity; all 24 lesions showed slightly hyperintensity on T(2)WI, and isointensity or slightly hyperintensity on DWI. The mean ADC value was (1.511±0.415)×10(-3) mm(2)/s in the lesions and (1.769±0.690)×10(-3) mm(2)/s in the adjacent hepatic parenchyma, which showed no difference between the two groups (0.05). On dynamic MR images, 20 lesions showed gradually filling enhancement, 4 lesions showed markedly and persistent enhancement. Punctiform or filiform vessels were found in 9 lesions. Adjacent hepatic perfusion disorders showed in 8 lesions. The median lesion size was 7.5-38.5(17.6±9.8) mm in the tumor-related-chemotherapy group and 9.0-72.0(33.8±21.2) mm in the no chemotherapy group.There was significant difference between the two groups (0.05). The MRI performance of focal peliosis hepatis had a certain characteristic. MRI combined with diffusion weighted imaging could help to make diagnoses.

摘要

探讨局灶性肝紫癜的MRI及扩散加权成像(DWI)特征。回顾性分析2012年1月至2018年3月在复旦大学附属中山医院经病理证实的19例局灶性肝紫癜患者的临床资料及MRI表现。分析病变的数量、位置、大小、形态、平扫信号强度、病变强化方式、病变内血管及肝实质灌注异常情况。测量病变及相邻肝实质的表观扩散系数(ADC)值,并进行统计学差异分析。将24个病变分为与肿瘤相关化疗的A组和未进行与肿瘤相关化疗的B组,对两组的MR特征差异进行统计学分析。24个病变中,22个位于右叶,2个位于左叶。中位大小为7.5~72.0(24.4±17.2)mm。在T(1)WI上,21个病变呈稍低信号,1个病变呈稍高信号,2个病变呈等信号;24个病变在T(2)WI上均呈稍高信号,在DWI上呈等信号或稍高信号。病变的平均ADC值为(1.511±0.415)×10(-3)mm(2)/s,相邻肝实质的平均ADC值为(1.769±0.690)×10(-3)mm(2)/s,两组间差异无统计学意义(P>0.05)。动态MR图像上,20个病变呈渐进性填充强化,4个病变呈明显持续性强化。9个病变内见点状或线状血管。8个病变出现相邻肝灌注异常。与肿瘤相关化疗组病变中位大小为7.5~38.5(17.6±9.8)mm,未化疗组为9.0~72.0(33.8±21.2)mm,两组间差异有统计学意义(P<0.05)。局灶性肝紫癜的MRI表现具有一定特征性。MRI联合扩散加权成像有助于诊断。

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