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目的探讨MRI平扫及动态增强在肝脏炎性假瘤(IPL)诊断与鉴别中的价值。资料与方法回顾性分析行Gd-DTPA动态增强MRI检查并经手术病理证实的IPL12例13个病灶,重点观察病灶在动态增强扫描中的强化方式及特点。结果12例患者共发现13个病灶,在T1WI上,4个病灶呈等信号,其余呈低信号。在T2WI上,6个病灶呈高信号,4个呈等信号,3个呈低信号。动态增强扫描后,病灶强化方式及特点如下:(1)全部病灶呈延迟强化;(2)动脉期4个病灶可见强化,其余无明显强化;(3)门静脉期和延迟期可见周边部环形强化(9/13,69.23%)、分隔样强化(6/13,46.15%)、中心或偏心性小结节状强化(2/13,15.38%)、全瘤不均质强化(1/13,7.69%);(4)延迟期病灶内存在无强化区(7/13,53.85%);(5)延迟期病灶缩小感(4/13,30.77%)。结论MRI动态增强扫描可反映IPL的血供特点及病理特征,对定性诊断与鉴别有较高的临床价值。
Objective To investigate the value of MRI plain scan and dynamic enhancement in the diagnosis and differential diagnosis of inflammatory pseudotumor (IPL) in the liver. Materials and Methods Retrospective analysis of 12 cases of IPL in 12 cases with Gd-DTPA dynamic contrast-enhanced MRI and confirmed by surgery and pathology was carried out. Focusing on the enhancement modes and features of lesions in dynamic contrast-enhanced scan were retrospectively analyzed. Results A total of 13 lesions were found in 12 patients. On T1WI, 4 lesions showed equal signal and others showed low signal. On T2WI, 6 lesions showed high signal, 4 showed equal signal and 3 showed low signal. After dynamic contrast-enhanced scanning, the enhancement modes and features of the lesion were as follows: (1) all the lesions showed delayed enhancement; (2) the four lesions in the arterial phase were strengthened and the rest were not significantly enhanced; (3) (9/13, 69.23%), segmental enhancement (6/13, 46.15%), central or eccentric nodular enhancement (2/13, 15.38% 7.69%). (4) There was no enhancement zone in the delayed stage of the lesion (7/13, 53.85%). (5) The lesser extent of the lesion in the delayed stage (4/13, 30.77%). Conclusions MRI dynamic contrast-enhanced scan can reflect the characteristics of blood supply and pathological features of IPL and has high clinical value for qualitative diagnosis and differential diagnosis.