MRI检查对肝脏Ⅰ、Ⅳ段CT上不典型脂肪肝的诊断价值
王警建，王龙龙，李娜，高延忠
（西安市第九医院，陕西 西安，710054）
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摘要：
目的 探讨MRI 检查对肝脏Ⅰ、Ⅳ段CT 上不典型脂肪肝的诊断价值及形成机制。方法 随机选取我院2014年5月至 2016年5月收治的Ⅰ、Ⅳ肝脏段CT上不典型脂肪肝患者36 例，所有患者均接受CT 和MRI 检查，对36例患者的类型及其病灶分布、CT检查和MRI检查表现进行观察。结果 36 例患者中，局灶型脂肪肝10 例（12个病灶），其中单灶8例，双灶2例；在病灶位置方面，2例患者为Ⅰ段（2个病灶），8 例患者为Ⅱ段（10个病灶）。肝岛26例（32个病灶），其中单发20 例，多发 6例；在病灶位置方面，4例患者为Ⅰ段（4个病灶），22例患者为Ⅱ段（28个病灶）。CT检查均没有确切诊断这些患者，MRI常规扫描只能将少数具有较多脂肪含量的病灶辨认出来，而12个局灶型脂肪肝病灶同相位像上的信号强度显著高于反相位像上的信号强度，和周围肝组织相比病变具有显著较高的信号；32个肝岛均没有较低的信号强度出现在反相位像上，而周围肝组织则具有显著较低的信号强度，使肝岛具有更为清晰明确的高信号，进而显著提升了肝岛和肝脏之间的信号对比度。结论 MRI 检查中化学位移同、反相位检查对肝脏Ⅰ、Ⅳ段CT上不典型脂肪肝具有较高的诊断价值，体循环的一些异常或异 位动脉或正常或迷走静脉供血可能为其重要的好发因素。
关键词：MRI 检查；Ⅰ、Ⅳ肝脏段CT 上不典型脂肪肝；形成机制
中图分类号：R445.2文献标志码：A文章编号：2096-1413(2017)01-0121-03
Diagnostic value of MRI examination in Ⅰ、Ⅳ segment atypical fatty liver diagnosed by CT
WANG Jing-jian, WANG Long-long, Li Na, GAO Yan-zhong
(the Ninth Hospital oF Xi an, Xi an 710054, China)
ABSTRACT: Objective To study the diagnostic value and formation mechanism of MRI examination in Ⅰ、Ⅳ segment atypical fatty liver diagnosed by CT. Methods Thirty-six cases of patients with Ⅰ、Ⅳ segment atypical fatty liver diagnosed by CT who were treated in our hospital from May 2014 to May 2016 were randomly selected, all patients were given CT and MRI check, then the type and distribution of lesions, CT and MRI examination showing of the 36 cases of patients were observed. Results Among the 36 cases of patients, focal type of fatty liver had 10 cases (12 lesions), including single lesion with 8 cases, double stove with 2 cases; in lesion location aspect, segment Ⅰhad 2 cases (2 lesions), Ⅱ paragraph had 8 cases (10 lesions). Liver island had 26 cases (32 lesions), including single 20 cases, multiple 6 cases; in terms of the location of lesions, segment Ⅰhad 4 cases (4 lesions), Ⅱ paragraph had 22 cases (28 lesions). CT examinations had no precise diagnosis of these patients, MRI routine scanning only recognized few number of lesions with more fat content, and signal strength 12 focal fatty liver lesion type on the same phase were significantly higher than reverse phase image signal strength, which had significantly higher signal than the surrounding liver tissue lesions; 32 liver Island did not appear in the lower signal intensity on the opposition like, while the surrounding liver tissue had significantly lower signal strength, the liver island had more clearly defined high signal, and thus significantly improved the signal contrast between the liver and liver island. Conclusion Chemical shift, reverse-phase examination in MRI examination has higher diagnostic value in Ⅰ、Ⅳ atypical fatty liver in liver segment CT, some unusual or ectopic or normal or vagus arterial circulation or venous blood may be its important predilection factors.
KEYWORDS: MRI examination; Ⅰ、Ⅳ atypical fatty liver in liver segment CT; formation mechanism
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