ABSTRACT
Objective@#To investigate the CT and MR imaging features of hepatic ischemia/necrosis after hepatosplenic surgery and upper gastrointestinal hemorrhage.@*Methods@#A total of 36 patients diagnosed with hepatic ischemia/necrosis by both medical imaging and clinical diagnosis shortly after hepatosplenic surgery and upper gastrointestinal hemorrhage were collected, including 9 patients with liver cancer resection, 5 patients with liver cancer ablation (microwave ablation/radiofrequency ablation, argon-helium knife, alcohol injection), 11 patients with spleen resection, and 11 patients with upper gastrointestinal bleeding. Conventional liver CT and / or MR plain and dynamic enhancement scan were performed to comprehensively analyze the morphology and density/signal performance of the lesions.@*Results@#(1) Number of lesions: All cases had multiple lesions. (2) Distribution of lesions: scattered in the liver lobes, clustered or regional distribution, mainly in the periphery of the liver. (3) Size of lesions: the boundary of the nodular lesion was clear, and the single maximum diameter was 1.0-1.5 cm. It can be fused into a wedge-shaped patch or a segmental/sub-segmental large patch with a slight mass effect. (4) CT density or MR signal characteristics: CT plain scan showed slightly low density; MR plain scan showed slightly low signal on T1WI, high signal on T2WI, slightly high signal on DWI and no lipid/fat on dual phase imaging; 24 out of 36 cases (66.7%) showed no enhancement, while some lesions showed thin ring enhancement on the edge; emboli were found in the main and/or branches of portal vein (21/36 cases, 58.3%). (5) In the short-term review (minimum 5 days), the lesions became smaller or disappeared, and the local liver volume became smaller or the surface was depressed.@*Conclusions@#Hepatic ischemia/necrosis occurs after hepatosplenic surgery and upper gastrointestinal hemorrhage. The imaging manifestations are multiple nodular or flaky hypovascular foci, and the short-term review shows a markedly improvement. It needs to be differentiated from infection and metastasis of malignant tumors after operation.
ABSTRACT
Objective To investigate the CT and MR imaging features of hepatic ischemia/necrosis after hepatosplenic surgery and upper gastrointestinal hemorrhage.Methods A total of 36 patients diag-nosed with hepatic ischemia/necrosis by both medical imaging and clinical diagnosis shortly after hepato-splenic surgery and upper gastrointestinal hemorrhage were collected,including 9 patients with liver cancer resection,5 patients with liver cancer ablation(microwave ablation/radiofrequency ablation,argon-helium knife,alcohol injection),1 1 patients with spleen resection,and 11 patients with upper gastrointestinal bleeding.Conventional liver CT and/or MR plain and dynamic enhancement scan were performed to com-prehensively analyze the morphology and density/signal performance of the lesions.Results(1)Number of lesions:AU cases had multiple lesions.(2)Distribution of lesions:scattered in the liver lobes,clustered or regional distribution,mainly in the periphery of the liver.(3)Size of lesions:the boundary of the nodu-lar lesion was clear.and the single maximum diameter Was 1.0-1.5 ca.It can be fused into a wedge-shaped patch or a segmental/sub-segmental large patch with a slight mass effect.(4)CT density or MR sig-nal characteristics:CT plain scan showed slightly low density;MR plain scan showed slightly low signal on T1 WI,high signal on T2WI,slightly high signal on DWI and no lipid/fat on dual phase imaging;24 out of 36 cases(66.7％)showed no enhancement,while some lesions showed thin ring enhancement on the edge;emboli were found in the main and/or branches of portal vein(21/36 cases,58.3％).(5)In the short-term review(minimum 5 days),the lesions became smaller or disappeared,and the local liver volume be-came smaller or the surface was depressed.Conclusions Hepatic ischemia/necrosis OCCURS after hepato-splenic surgery and upper gastrointestinal hemorrhage.The imaging manifestations are multiple nodular or flaky hypovascular foci,and the short-term review shows a markedly improvement.It needs to be differentia-ted from infection and metastasis of malignant tumors after operation.