小儿肝脏间叶性错构瘤的MRI表现  

Mesenchymal hamartoma of the liver in child: magnetic resonance imaging manifestation

作　　者：叶滨宾[1] 王丽君[1] 胡冰[1] 刘鸿圣[1] 范淼[1] 张志鹏[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080

出　　处：《中华放射学杂志》2005年第7期743-747,共5页Chinese Journal of Radiology

摘　　要：目的肝脏间叶性错构瘤是1种少见的肝脏良性肿瘤。方法搜集经MRI检查后手术或穿刺病理证实的12例,总结其MRI表现,以其提高对本病的认识和正确诊断。12例患儿,男7例,女5例。年龄1·2个月至12岁,平均6·3岁。主要症状为:腹部包块(5例),肝大(8例),腹痛、贫血(3例)。甲胎蛋白阴性。采用Elscint2·0T磁共振装置,SE、快速梯度回波(FSE)序列,横断、矢状、冠状面扫描,有2例为平扫加动态增强扫描。结果单发结节型6例,其中3例为实性为主,T1WI为稍低信号,T2WI为不均匀高信号;1例为囊实混合性,为实性肿块中可见大小不等边界清楚的囊;2例囊性为主,表现为多房分隔的囊性肿块。弥漫及多发结节型5例,结节大小不等、边界清楚信号同实性肿块。弥漫及单发囊性肿块并存者1例。增强扫描早期病灶轻度环形强化,延迟扫描渐向中心强化。肝内血管受压者5例,腔静脉及腹主动脉受压者3例。病理所见:镜下见纤维增生成片,透明变性,其中小胆管增生,小叶状排列;囊性者部分囊壁内衬单层扁平上皮细胞或胆管上皮,部分为结缔组织裂隙,囊内充满液体或胶样物质。结论MR检查是鉴别和诊断小儿肝间叶性错构瘤的较好方法,应该认识其MRI表现。Objective To describe the MR imaging features of mesenchymal hamartoma of the liver (MHL) in child with comparison with histopathologic results. Methods Tweleve children with MHL (7 male and 5 female, age ranging from 1.2 months to 12 years ) underwent MR examination by using SE and FSE sequences. Main symptoms were abdominal mass (5 cases), hepatomegaly (8 cases), abdominal pain (1 case) and anemia (2 cases). Alphafetoprotein was negative in all cases. Dynamic enhancement examinations were added in 2 cases. Results Six cases were single mass type, in which 3 cases were solid masses showing slight low SI on T1WI and irregular high SI on T2WI. 1 case was a mixed mass with both cystic and solid component showing several cysts in a solid mass. 2 cases were cystic masses with multi-septum. Five cases were diffuse and multifocal lesions type of which the signal intensity was similar to the solid mass. Diffuse cystic mass in one case.The lesions showed marginal enhancement slightly on the early stage of dynamic enhancement examination, with central enhanced on the delayed scan. Intrahepatic vessels were compressed in 5 cases, while the inferior vena cava and abdominal aorta were compressed in 3. Pathological findings showed fibrohyperplasia, hyaline degeneration, and biliary duct hyperplasia. Conclusion MR imaging is a useful and reliable method for the detection and diagnosis of MHL.

关 键 词：肝脏间叶性错构瘤 MRI表现 小儿 肝间叶性错构瘤 肝脏良性肿瘤 甲胎蛋白阴性 快速梯度回波 动态增强扫描 实性肿块 囊性肿块 磁共振装置 冠状面扫描 囊实混合性 多发结节型 病理证实 正确诊断 腹部包块 主要症状 T1WI T2WI 

分 类 号：R735.7[医药卫生—肿瘤] R739.45[医药卫生—临床医学]