肝脏非特异性嗜酸性肉芽肿的影像学特征

Imaging characteristics of hepatic eosinophilic granuloma

  • 摘要: 肝脏嗜酸性肉芽肿是由长期炎症引起肉芽肿形成继而发生。本文分析2008年7月至2012年4月烟台市烟台山医院和烟台市毓璜顶医院收治的2例肝脏非特异性嗜酸性肉芽肿患者的临床资料,并总结其影像学特征。实验室检查均提示患者外周血嗜酸性粒细胞增高,超声检查发现低回声肝脏包块,彩色多普勒检查无血流信号。CT检查示略低密度病灶,边界欠清晰,增强扫描示延迟期不均匀强化,病灶呈网格状改变。1例患者接受MRI检查,T1WI 扫描示病灶呈不规则略高信号,边缘欠清晰,其内见一斑片状低信号;T2WI扫描呈高信号,内见低信号分隔;DWI扫描呈明显高信号。熟悉肝脏非特异性嗜酸性肉芽肿的影像学特征,并结合外周血嗜酸性粒细胞增高,可以帮助临床医师作出正确诊断。

     

    Abstract: Hepatic eosinophilic granuloma is a rare benign liver lesion, which results from granuloma formation due to chronic inflammation. Two patients were admitted to the Yantaishan Hospital and Yuhuangding Hospital from July 2008 to April 2012, respectively. The results of laboratory examination showed the elevation of peripheral blood eosinophils, and ultrasound examinations revealed lowecho masses in the liver and no blood flow was detected. The results of computed tomography showed hypoattenuation lesions with welldemarcated boundary. After intravenous administration of contrast angent, the lesions demostrated delayed heterogeneous enhancement with internal grid. The results of magnetic resonance imaging of 1 patient showed the lesion had slight hyperintensity to the surrounding liver parenchyma on T1weighted images, and slight high signal with low signal separation strip inside on fatsuppressed T2weighted images. An obvious high signal was detected in diffusion weighted imaging. Familiarity with the imaging characteristics and combination of the elevation of peripheral eosinophil can help surgeons to make a suggestive diagnosis.

     

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