Intrahepatic calcification

Introduction Intrahepatic calcification refers to a strong echo or high-density image resembling a stone in the liver on a B-ultrasound or CT image. It is more common in people aged 20-50 years. The incidence of men and women is equal. It is usually a single calcification, and the right liver is more. In the left liver, there are few left and right liver calcifications.

Cause

There are many lesions that form intrahepatic calcifications, including

1 intrahepatic bile duct stones are the most common factors;

2 chronic inflammation or trauma in the liver;

3 parasitic infections;

4 liver benign and malignant tumors and intrahepatic metastatic calcification;

5 congenital development, the fetus in the uterus has intrahepatic calcification, often associated with congenital malformation, the rate of discovery is 0.057%.

an examination

Related inspection

CT, radiological imaging of liver, gallbladder and spleen

1, the diagnosis and identification of intrahepatic calcifications preferred B-ultrasound.

2, CT resolution is high, showing clear calcification, mainly used for B-ultrasound to identify intrahepatic calcification, especially when intrahepatic metastases are suspected.

3. Most intrahepatic calcifications are accidentally discovered during normal physical examination. For single or multiple isolated calcified foci in the liver, there are no symptoms and signs, and there is no abnormality in liver size and morphology, which may be related to congenital development and nutrition. Impaired, calcium and phosphorus metabolism disorders or damage and other factors, may also be some lesions, such as intrahepatic bile duct stones, liver abscess or liver wound healing. The B-ultrasound image of this type of intrahepatic calcification is characterized by a strong echo that is scattered in the shape of "character" or "equal sign". It travels outside the bile duct, mostly without sound shadow or light shadow, and without intrahepatic bile duct. expansion. There is no need for treatment for this type of intrahepatic calcification. For the sake of caution, this type of calcification can be followed up for 2 to 3 years, and B-ultrasound is reviewed every 3 to 6 months.

Differential diagnosis

Differential diagnosis of intrahepatic calcification:

1, hepatic amyloidosis: pathogenesis of hepatic venular occlusion: hepatic sinus expansion symptoms in the acute phase and subacute phase.

In the acute phase, the liver is enlarged and the surface is smooth, and lymphatic vessel expansion and "liver crying" signs are seen. Under the light microscope, the central vein and the inferior venous intima were significantly swollen, the lumen was narrowed or occluded, the blood flow was blocked, and the hepatic sinus was obviously dilated and congested with varying degrees of hepatocyte turbidity, swelling and necrosis. Hepatocytes disappeared in the area of necrosis, residual reticular fiber scaffolds, red blood cells infiltrated into the hepatic sinus and Dissel's space, and typical hemorrhagic necrosis changes.

In the subacute phase, the surface of the liver is reticulated, and the central vein and the subvalvular venous endothelium proliferate and thicken to form fibrosis and stenosis.

2, liver fibrosis: liver fibrosis refers to the pathological process of abnormal proliferation of connective tissue in the liver caused by various pathogenic factors, leading to excessive deposition of diffuse extracellular matrix in the liver. It is not an independent disease, but many chronic Liver disease can cause liver fibrosis, and its etiology can be roughly divided into infectious (chronic B, C and D viral hepatitis, blood tsutsugamushi, etc.), congenital metabolic defects (hepatic nucleus degeneration, blood color Disease, 1-antitrypsin deficiency, etc.) and chemical metabolic defects (chronic alcoholic liver disease, chronic drug-induced liver disease) and autoimmune hepatitis, primary hepatic cirrhosis and primary sclerosing cholangitis.

diagnosis:

Intrahepatic calcification is the first choice for B-ultrasound; CT resolution is high, showing clear calcification, mainly used for B-ultrasound to identify intrahepatic calcification, especially when intrahepatic metastases are suspected. Most intrahepatic calcifications are accidentally discovered during normal physical examination. For single or multiple isolated fused calcifications in the liver, there are no symptoms and signs, and the size and shape of the liver are not abnormal, which may be related to congenital development and malnutrition. Calcium and phosphorus metabolism disorders or damage and other factors, may also be some lesions, such as intrahepatic bile duct stones, liver abscess or liver wound healing. The B-ultrasound image of this type of intrahepatic calcification is characterized by a strong echo that is scattered in the shape of "character" or "equal sign". It travels outside the bile duct, mostly without sound shadow or light shadow, and without intrahepatic bile duct. expansion. There is no need for treatment for this type of intrahepatic calcification. For the sake of caution, this type of calcification can be followed up for 2 to 3 years, and B-ultrasound is reviewed every 3 to 6 months.

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