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目的探讨肝脏炎性假瘤(IPTL)“厚壁圆环中心点”征的CT与MR表现特点。方法搜集经病理诊断(8例)及临床诊断(9例)的IPTL共17例常规肝脏CT及/或MR平扫及动态增强资料,综合分析病灶的形态及密度/信号表现。结果 (1)全部病例病变影像形态学均可分为两部分,即“厚壁圆环”和“中心点”。“厚壁圆环”表现:厚壁结构占病灶大部;部分/全部呈较明显类圆形,内外缘较清晰;呈多层不同厚度、欠规则同心环状,但整体厚度较均匀一致;呈渐进性强化。“中心点”表现:中心区仅占小部分或呈近似点状;每个病灶内可为一点或多点;各期无强化。(2)17例患者中单发11例,双发或多发6例、其中2例弥漫多发。(3)单发或散在多发“厚壁圆环中心点”14例,多个该结构融合(7例,其中部分病例为多发病灶中的部分融合)。(4)病变各部无固定CT密度值或MR信号特征。(5)病理证实的8例占同期纳入研究的IPTL病例的21.6%(8/37)。结论 “厚壁圆环中心点”征是部分IPTL的一个较特异影像征象,能否作为IPTL的一种独立影像分型有待进一步研究。
Objective To investigate CT and MR features of inflammatory pseudotumor (IPTL) and central point of thick wall ring. Methods A total of 17 cases of conventional liver CT and / or MR plain scan and dynamic enhancement data were collected from IPTL, pathologically diagnosed (8 cases) and clinically diagnosed (9 cases), and their morphological and density / signal manifestations were analyzed comprehensively. Results (1) All cases of lesion image morphology can be divided into two parts, namely “thick ring ” and “center ”. “Thick-walled ring ” performance: thick-walled structure accounted for the majority of lesions; part / all was more obvious round, inner and outer edges more clearly; was multi-layer different thickness, less regular concentric rings, but the overall thickness more uniform Consistent; progressive enhancement. “Center point ” performance: the center area is only a small part or almost point-like; each lesion can be one or more points; each period without strengthening. (2) Of the 17 patients, 11 were single, 6 were double or multiple, of which 2 were multiple. (3) Single or scattered multiple “thick-walled ring center point” in 14 cases, a number of the structure fusion (7 cases, some of which cases of partial fusion of multiple lesions). (4) Lesions without fixed CT density or MR signal characteristics. (5) Pathologically confirmed 8 cases accounted for 21.6% (8/37) of the IPTL cases studied in the same period. Conclusion The “thick-walled ring center point” sign is a specific image sign of some IPTLs. Whether it can serve as an independent image classification of IPTL remains to be further studied.