脂肪肝内正常肝岛及正常肝内局灶脂肪变性的CT与MR诊断VIP专享VIP免费

作者单位:510080广东省人民医院放射科脂肪肝内正常肝岛及正常肝内局灶脂肪变性的CT与MR诊断梁长虹黄飚黄美萍郑君惠谭绍恒曾琼新摘要目的:探讨脂肪肝内正常肝岛及正常肝内局灶脂肪变性的CT与MR征象。方法:6例脂肪肝内正常肝组织岛(A组)与7例正常肝内局灶性脂肪变性(B组)病人,CT与常规SET1及T2加权及梯度回波T1加权in-phase及out-phaseMR成像。结果:增强前、后CT显示正常肝组织岛保持正常肝组织与脾脏密度关系;肝组织局灶脂肪变性呈相对低密度。MRISET1、T2加权成像及梯度回波in-phaseT1加权成像显示正常肝组织岛相对低信号区;局灶脂肪变性区呈稍高信号。梯度回波out-phaseT1加权成像正常肝组织岛呈高信号;局灶脂肪变性区呈低信号。脂肪抑制T2加权成像均呈等信号。结论:采用MR的梯度回波out-phaseT1加权及TSET2加权脂肪抑制成像可以诊断正常肝岛及正常肝内的局灶脂肪变性。关键词肝脏脂肪变性断层,X线计算机磁共振成像NormalTissueIslandinFattyLiverandFocalFattyInfiltrationinNormalLiver:CTandMRILiangChanghongHuangBiaoHuangMeipingZhengJunhuiTanShaohengZengQongxinDepartmentofRadiology,GuangdongProvincialHospital,Guangghou510080ABSTRACTObjective:Toevaluatethefindingsofnormaltissueislandinfattyliverandfocalfattyinfiltrationinnormalliv2eronCTandMRI.Methods:Sixcasesofnormaltissueisland(NTI)infattyliverandsevencasesoffocalfattyinfiltration(FFI)innormalliverwerestudied.MRIsequencesincludedSET1-weightedimaging,TuborSE(TSE)T2-weightedimaging,postcontrastSET1-weightedimaging,tuborfieldecho(TFE)in-phaseandout-phaseT1-weightedimaging.Results:Onpre-andpostcon2trastCT,NTIsinsixcaseswereshowedashyperdensityareasandkepttherelationshipbetweenthenormalliverandthespleen,andFFIsinsevencaseswereappearedashypodensityareas.OnSET1-weighted,TSET2-weightedandFFEin-phaseT1-weightedimages,sixNTIsappearedashypointensity,andsevenFFIsasslighthyperintensity.OnFFEout-phaseT1-weightedimages,NTIsweredemonstratedashyperintensityareasandFFIsashypointensityareas.OnSPIRT2-weightedimages,NTIsandFFIswereshowedasisointensity.Conclusion:WebelievedthatNITandFFIcanbediagnosedbyFFET1out-phaseimagingandTSESPIRT2-weightedimaging.KeywordsLiverFattyinfiltrationTomography,X-raycomputedMRI肝脂肪变性在临床上比较多见。脂肪肝内正常肝岛及正常肝内局灶脂肪变性均为临床上的影像学诊断难题[1]。文献中尚未见有关此二者的CT及MR诊断的报道。本文从CT及MRI两方面来探讨这两者的诊断问题。1材料与方法本组前瞻性地研究了6例脂肪肝内存在正常的肝岛(A组)及7例正常肝内局限性脂肪变性的病例(B组)。A组中男、女性各3例,年龄21～45岁。B组中男性2例及女性5例,年龄32～52岁。所有病例均经CT、MR扫描及肝动脉造影。所有病例均为临床诊断证实:①经追踪复查6月至1年,病灶大小及形态无变化。②病人无原发性恶性肿瘤。③血清学检查,甲胎球蛋白定量分析小于25mg�L。④选择性肝动脉造影无异常征象。CT扫描使用PickerPQ2000检查A组中5例及B组所有病例,ElscentCTTwin检查A组中1例。增强前后均采用10mm层厚连续扫描,增强后连续动态扫描正常肝岛及局灶脂肪变性区。增强扫描使用高压注射器肘前静脉内注射60%优维显50～100ml,开始注射造影剂10s后开始扫描。MR检查使用为PhilipsACS-NT151.5T超导扫描仪。检查方法为常规自旋回波(SE)T1加权及快速自旋回波(TSE)T2加权横断面扫描,层厚10mm及层间距1mm。快速场回波扫描(TFE)T1加权成像,TR为15ms,翻转角30,分别用TE为4.6ms(in-phase,同相位)及6.9ms(out-phase,反相位)进行二次相同解剖层面横断层扫描。扫描时屏气,每次屏气17～20s,扫描3～6层。MRI增强扫描方法为5s内静脉注射076实用放射学杂志1999年11月第15卷第11期©1994-2010ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.http://www.cnki.net0.1mmol�kg马根维显或钆喷酸葡胺后FFET1加权成像动态扫描及SE增强T1加权成像。...