摘要
目的:探讨血色病的腹部影像学的特征,评价腹部影像学、肝脏活检组织病理学检查在血色病诊断中的作用。方法:回顾分析4例诊断为血色病临床资料完整的患者,对其腹部影像学、病理组织学和特殊染色的特点进行分析。结果:遗传性血色病3例,继发性血色病1例,2例CT扫描肝脏及脾脏均呈显弥漫性增大,肝脏及脾脏密度呈弥漫性增高1例,肝脏密度正常1例,胰腺密度均正常。T2WI肝脏呈低信号4例,脾脏呈均匀低信号3例,呈"胡椒盐"样低信号1例,胰腺信号减低3例。T1WI肝脏呈低信号4例,脾脏呈低信号3例,呈"胡椒盐"样低信号1例,胰腺信号减低3例。伴有少量胸腔及腹腔积液1例。1例肝脏组织活检HE染色及普鲁士蓝染色见大量铁沉积,另1例见少量铁沉积。结论:血色病的MRI及CT的表现都具有特征性征象,但MRI较CT的表现更具有特异性,MRI的T2WI呈低信号是诊断本病的特异性征象,肝脏组织活检是诊断本病的金标准。
Objective： To discuss the abdominal imaging characteristics of hemochromatosis, and to as- sess the value of abdominal imaging and liver biopsy pathology findings in its diagnosis. Methods： We retrospectively analyzed the radiological and pathological findings in four cases diagnosed as hemochromatosis with complete clinical information. Results： There were three cases of heredi- tary hemochromatosis and one case of secondary hemochromatosis. The liver and spleen showed significant diffuse enlargement by CT in 2 cases, diffuse density increase in 1 case, and normal density in the other cases. Density of pancreas was normal in all cases. By MRI, livers in 4 cases showed low signal of T2WI, spleens in 3 cases showed low signal and in the other one showed pepper-salt like low signal. Livers in 4 cases showed low signal of TlWI. Spleens showed low signal of TlWI in 3 cases, and 1 case showed pepper-salt like low signal. Pancreas showed low signal of TlWl and T2WI in 3 cases. There was a small amount of pleural and peritoneal effusion in 1 case. Liver biopsy showed lots of iron deposit by hematoxylin-eosin （HE） staining and prus- sian blue staining in 1 case, and a small amount of iron deposit in another case. Conclusion： MRI and CT manifestations in hemoglobin disease have characteristic signs, while it is of more specificperformance in the disease being diagnosed by MRI than that by CT. The low signal of T2WI is the characteristic sign. In addition, liver biopsy is the golden standard of the hemochromatosis.
出处
《武汉大学学报（医学版）》
CAS
2015年第4期584-587,共4页
Medical Journal of Wuhan University
