【摘要】 目的 探讨肝内病变在动态增强时出现环状强化的病理对照研究。方法 回顾性分析58例肝内病变出现环状强化的影像表现,并与组织学对照及分析其影像机制。结果 本组病例包括:(1)肝细胞癌11例,组织学表现肝癌包膜强化与肿瘤边缘纤维间质内的新生血管相关。(2)胆管细胞癌9例,病理提示肿瘤边缘存在丰富的纤维间质和新生血管。(3)肝转移癌13例,病理显示肿瘤向周围肝实质浸润,导致肝组织受压和肝板萎缩。(4)肝脏上皮样血管内皮瘤1例,移植肝的组织学显示肿瘤周围肝实质受侵。(5)肝脓肿11例,病理显示强化环由内向外为肉芽组织、纤维组织及水肿带。(6)肝腺瘤3例,强化包膜的病理为病灶周围受压的肝实质和轻度纤维化。(7)肝脏血管瘤10例,病理对照显示强化环由囊样扩张和薄壁的大血管构成,血管腔内充盈红细胞。结论 肝内病变出现的环状强化与其不同的组织结构相关,MR对这种影像表现的显示强于CT。更多还原

【Abstract】 Objective The purpose is to describe and determine the circumferential perilesional enhancement correlated with pathologic features of intrahepatic lesions.Methods Fifty-eight patients with circumferential enhancement underwent MDCT and MRI(21 cases) scan were retrospectively reviewed and compared with histopathologic findings obtained after liver biopsy,hepatic surgery and liver transplant.Results(1) Hepatocellular carcinoma in 11 cases,histopathologic result showed that perilesional enhancing rim was correlated with the neovessels of the fibrous at the tumor margin.(2) Cholangiocarcinoma in 9 cases,histopathologic result showed that rich fibrous and neovessels was at the tumor margin.(3) Hepatic metastases in 13 cases,histologic specimen demonstrated prominent peritumoral compressed hepatic parenchyma and invasion.(4) Hepatic epithelioid hemangioendothelioma in 1case,transplant specimen demonstrated peritumoral hepatic parenchyma invasion.(5) Hepatic abscess in 11 cases,histopathologic result showed that perilesional enhancing rim was composed with granulation tissue,fibrous and edematous band.(6) Hepatic adenoma 3 cases,pathologic specimen demonstrated a pseudocapsule corresponded to abnormal compression of adjacent hepatic parenchyma and mild fibrosis.(7) Hepatic hemangioma in 10 cases,histological findings of surgery specimen revealed the lesion was composed of large vessels with cystically dilated and thin walls.Lumen of blood vessels was filled with erythrocytes.Conclusion The imaging of the circumferential perilesional enhancement of intrahepatic lisions is correlated with the perilesional histopathologic findings.MRI has more advantages than CT in depiction of circumferential perilesional enhancement.更多还原