原发于肝十二指肠韧带病变的MRI诊断
MRI Diagnosis of Primary Mass in Hepatoduodenal Ligament
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摘要: 目的 探讨肝十二指肠韧带 (HDL) 的正常解剖及原发于HDL病变的磁共振 (MRI) 表现, 评价原发于HDL病变MRI的诊断.方法 回顾分析2004年8月至2013年10月昆明医科大学第二附属医院经药物 (抗结核) 或手术治疗、病理证实的肝十二指肠韧带原发病变11例, 均行MRI平扫、增强检查.结果 11例均为良性病变, 其中淋巴结结核3例, 神经鞘瘤2例, 神经纤维瘤1例, 畸胎瘤1例, 淋巴管瘤2例, 单纯囊肿2例.其中1例予抗结核治疗9个月后复查病变减少.另10例手术均完整切除, 随访3月至5 a未见复发.结论 MRI对诊断原发于肝十二指肠韧带病变有良好的定位诊断价值, 其多方位成像对鉴别该区域来源于胆道、肝脏、胰腺、十二指肠的其他病变提供影像学依据.MRI良好的软组织分辨率有助于病变定性诊断及鉴别诊断.Abstract: Objective To explore the MRI imaging appearance of the normal anatomy and primary mass in hepatoduodenal ligament and to evaluate the diagnostic value of its abnormalities by MRI.Methods From August2004 to October 2013, 11 cases of lesions in hepatoduodenal ligament confirmed by drug therapy (antituberculosis therapy) or surgery and pathology were collected.All were performed plain and enhanced MRI.Results Eleven cases were benign lesions including lymph nodes tuberculosis in 3 cases, neurilemmoma in 2 cases, neurofibroma in1 case, teratoma in 1 case, lymphangioma in 2 case and simple cyst in 2 cases.There was no relapse after 3months5 years.Conclusion MRI has a good diagnostic value in locating the lesions in hepatoduodenal ligament and its multi-aspect image formation is very useful in differentiating other tumor developing from biliary tract, liver, pancreas or duodenum.Its good soft tissue resolving power is helpful for qualitative diagnosis and differential diagnosis.
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Key words:
- Liver /
- Duodenum /
- Ligament /
- Magnetic resonance imaging
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[1]汶雅娟, 马静, 王锋, 等.肝十二指肠韧带的正常解剖及CT研究[J].实用放射学杂志, 2003, 19 (2) :128-130. [2] [2]BALFE D M, MATTHEW A M, ROBERT E K, et al.Gastrohepaticligament:normal and pathologic CT anatomy[J].Radiology, 1984, 150 (2) :485-490. [3]关泉林, 徐长清, 李波, 等.原发性肝十二指肠韧带原发肿块15例分析[J].中国误诊学杂志, 2005, 5 (12) :2324-2325. [4]杨菲菲, 王家平, 段丽芬, 等.肝十二指肠韧带神经源性肿瘤的MRI诊断[J].放射学实践, 2010, 25 (1) :63-66. [5]郭东明, 李川, 文天夫, 等.肝十二指肠韧带原发肿块诊治分析 (附16例报道) [J].中国普外基础与临床杂志, 2014, 21 (7) :841-845. [6]惠延平, 马世荣, 程虹, 等.性腺外畸胎瘤172例临床病理分析[J].诊断病理学杂志, 2006, 13 (1) :17-20. [7]张浩川, 陈肖鸣.恶性畸胎瘤细胞体外诱导分化的研究进展[J].现代肿瘤医学, 2005, 13 (1) :119-121. [8]吕梁, 李杰.CT诊断肝十二指肠韧带畸胎瘤1例[J].中国临床医学影像杂志, 2009, 20 (1) :71. [9]黄磊, 许崇永, 赵雅萍, 等.小儿颈部淋巴管瘤的影像学表现[J].中华放射学杂志, 2005, 39 (8) :835-837. [10] [10]JEUNG M Y, GASSER B, GANGI A, et al.Imaging of cystic masses of the mediastinum[J].Radiographics, 2002, 22 (9) :79-93. [11]何英, 凌文武, 杨裕佳, 等.肝十二指肠韧带囊肿伴出血1例[J].中国医学影像技术, 2013, 29 (6) :927. [12] [12]POMBO F, RODRIGUEZ E, MATO J, et al.Patterns of contrast enhancement of tuberculous lymph nodes demonstrated by computed tomography[J].Clin Radiol, 1992, 46 (1) :13-17. [13]杨志刚, 闵鹏秋, 何之彦, 等.腹腔和腹膜后间隙结核的CT表现及其病理基础[J].中华放射学杂志, 1996, 30 (3) :155-158. [14]张梅.腹部淋巴结病变的断面影像学特征及其解剖、病理学基础[J].实用放射学杂志, 2004, 20 (2) :161-164. [15]周开伦.肝十二指肠韧带恶性间皮瘤1例[J].中国普通外科杂志, 1999, 8 (4) :250. [16]关泉林, 文天夫, 李波, 等.肝十二指肠韧带淋巴结结核七例诊治分析[J].中华肝胆外科杂志, 2006, 12 (5) :347-348. [17]葛巧, 倪桂宝.肝十二指肠韧带孤立性纤维性肿瘤1例报告及文献复习[J].实用肿瘤杂志, 2007, 22 (6) :518-520. [18]陈俏峰.肝十二指肠韧带异位肝一例[J].外科理论与实践, 2011, 16 (2) :206-207. [19] [19]DONG P, WANG B, SUN Y Q.Tuberculous abscess in hepatoduodenal ligament:evaluation with contrast-en hanced computed tomography[J].World J Gastroenterol, 2008, 14 (14) :2284-2287. [20] [20]BEGG I.Imaging of peripheral nerve tumors[J].Clin Radiol, 1997, 52 (1) :8-17. [21] [21]SAH J, ABENO P, GRALLOWAY H, et al.Peripheral (Extracranial) nerves tumors:Correlation of MR imaging and histology findings[J].Radiology, 1992, 183 (2) :341-346. [22]王晓琪, 张雪林, 杨星, 等.腹部神经源性肿瘤CT分析34例[J].放射学实践, 2002, 17 (6) :487-489. [23] [23]KIM S H, CHOI B L, HAN M C, et al.Retroperitonal neurilemoma:CT and MRI findings[J].AJR, 1992, 159 (4) :1023-1026. [24]许尚文, 张雪林, 曾建华, 等.不典型神经鞘瘤及神经纤维瘤CT、MRI诊断[J].临床放射学杂志, 2005, 24 (10) :862-865. [25]闵鹏秋, 林珊, 何之彦, 等.门腔间隙病变CT、MRI特征探讨[J].中华放射学杂志, 1996, 30 (1) :6-10.
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