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目的探讨肝脏多灶性结节状脂肪浸润(HMNFI)的CT和MRI影像表现。方法回顾性分析5例经穿刺活检或通过随访证实为HMNFI患者的CT及MRI资料。全部患者均行CT和MRI平扫及动态增强扫描。结果5例患者CT表现为肝实质内散在分布的多发结节状病灶,大小不等,无占位效应,平扫呈欠均匀低或稍低密度,边界清楚或稍模糊,部分边缘可见环形极低密度影包绕,动态增强扫描其强化方式类似肝实质,强化程度始终低于或于门静脉期及平衡期等强于正常肝实质。MRI T1WI同相位上病灶呈等信号,反相位上呈低或稍低信号,部分边缘可见环形低信号,T2WI及扩散加权成像(DWI)上表现为等或稍高信号,动态增强扫描表现与CT类似。结论HMNFI的CT及MRI影像表现有一定特点,尤其是MRI T1加权反相位图像具有特征性,有助于与肝内真性肿瘤进行鉴别。
Objective To investigate the CT and MRI findings of multifocal nodular fatty infiltration (HMNFI) in the liver. Methods The CT and MRI data of 5 patients with HMNFI confirmed by biopsy or follow-up were retrospectively analyzed. All patients underwent CT and MRI plain and dynamic enhanced scan. Results The CT findings of 5 patients were multiple, nodular lesions scattered in the liver parenchyma. The size of the nodules was variable with no space-occupying effect. The CT scan showed less uniform or slightly lower density, and the border was clear or slightly blurred. Low-density shadow wrap, dynamic contrast-enhanced scan similar to the liver parenchyma, the degree of enhancement is always lower than or in the portal vein and balance period is stronger than the normal liver parenchyma. MRI T1WI showed the same signal on the same phase, low or low signal in antiphase, low ring signal on the edge, equal or slightly higher signal on T2WI and DWI, dynamic contrast enhancement CT is similar. Conclusion The CT and MRI images of HMNFI have certain characteristics, especially the MRI T1-weighted anti-phase images are characteristic to help distinguish with true intrahepatic tumors.