【摘要】 目的总结慢性病毒性肝病的CT及MRI的直接征象和伴随影像特征,提高影像学诊断水平,评价其临床应用价值。方法回顾性分析33例慢性病毒性肝病患者的共41次影像学检查资料,其中,21例行CT检查,12例行MRI检查。动态增强扫描19例,其中CT增强13例,MRI增强6例。3例行MRI弥散成像。分析肝脏的形态、密度或信号变化及胆囊、脾脏改变,和动态增强扫描时肝脏的强化峰值时间。另外测量20例正常肝脏的动态增强扫描强化峰值时间。结果肝右叶体积缩小28例,肝脏边缘欠光整15例。肝脏密度或信号轻度不均匀18例,明显不均匀见弥漫砂砾状低密度或低信号者8例,以增强扫描实质期时显著。8例可见门静脉周围轨迹征。合并胆囊炎26例,胆囊结石8例。脾脏体积增大23例,其中6例复查患者脾脏较前稍增大。另有6例合并腹水(其中1例中量,5例少量),2例少量胸腔积液,12例胸膜增厚。3例可见肝门区淋巴结肿大。13例于动态增强扫描(其中CT9例,MRI4例)时肝脏的强化峰值时间为9～28s(平均14.8±8.2),20例正常肝脏的动态增强扫描强化峰值时间为5～18s(平均6.8±4.1)。2例MRI弥散成像可见肝内弥漫斑点状高信号影。结论CT和MRI对了解慢性病毒性肝病的病情进展具有重要意义,弥漫沙砾状低密度或低信号、门静脉周围轨迹征及肝脏强化峰值时间延迟等特征可协助明确诊断。更多还原

【Abstract】 Objective To summarize the direct signs and accompanied characteristic of CT and MRI imaging manifestations of chronic virus hepatitis, for the purpose of improving the level of imaging diagnosis and evaluating its value of clinical application. Methods Forty-one imaging datas from 33 cases with chronic virus hepatitis was analyzed retrospectively. CT scans were performed in 21 cases, and MR imaging in 12 cases. The changes of the morphous ,density or signal of liver, bile duct, spleen and portal venous system were observed, and the peak time of liver parenchyma enhancement was measured. Results Of 33 cases, the right liver reduced in size (n=28 cases), the margin of liver irregular (n=15 cases), inhomogeneous (n=18 cases), periportal tracking signs (n=8 cases), spleen swelling (n=23 cases), ascites (n=6 cases), pleural effusion (n=2 cases) and pleural thickening (n=12 cases) were recognized. The peak time of hepatic enhancement in 13 cases were 14.8±8.2 seconds at average. The widespread mottled hyperintensity was found at 2 cases in diffusion-weighted MR imaging. Conclusion CT and MRI had important significance in understanding the condition of patients with chronic virus hepatitis. The characteristic of widespread mottled hyperintensity, periportal tracking signs and delayed peak time of hepatic enhancement were made for definite diagnosis.更多还原