肝脏解剖与常见病影像诊断PPT.ppt

FNH影像特征 平扫密度信号与肝实质接近 强化明显 内部瘢痕 假包膜少见 肝腺瘤 Hepatocelluar adenoma 女, 1 8岁 增强：强化明显 男, 2 2岁 易出血 女性、23岁，MRI扫描 征象：包膜、脂肪 MRI advantages MRI is often used as a problem-solveing technique to give additional information to US and CT Excellent technique foe demonstrating tumours Images can be obtained in coronal and sagittal planes Intravenuous contrast is used to improve visualization and help charccterize lesions. New liver-specific agents: Some taken by the hepatocytes some by the reticuloendothelial cell MRI MRCP Multiple-phase Enhancement Arterial phase Equilibrium phase Delayed phase 90min Multihance liver-specific agents: specifically taken by the hepatocytes Portal vein phase Hepatocarcinoma can’t take the agent multihance Common liver diseases imaging Diffuse diseases: fatty liver, cirrhosis Focal diseases: Benign：Liver cyst, absecess, hemangioma Focal nodule hyperplasia(FNH) adenoma Malignant: heptocellular carcinoma cholangiocarcinoma metastasis tumors Fatty liver Relatively frequent finding Hypercholesterolaemia obesity or diabetes , alcohol addict and patients on chemotherapy or hormonotherapy Diffuse or local Fatty infiltration leads to a reduction in the attenuation of the affected parenchyma causing low density on CT scans 局灶性脂肪肝 Fatty liver Cirrhosis Pathology: Liver cell degeneration and necrosis, extensive fibrosis nodular regeneration---- liver structure and blood circulation system reconstruction Imaging Features: X ray：esophagus, the bottom of the stomach varices CT、MRIfindings 1/Shape morphology：hepatomegaly /atrophic , liver lobe ratio change, outer concave contour ，parenchymal nodular regeneration 2/Density: Inhomogeneous attenuation 3/ Contrast Enhancement (CE): inhomogeneous degree of enhancement, intrahepatic arterioportal fistulas 4/Extrahepatic findings: varices， scites, splenomegaly. 5/The differential d