肝脏上皮样血管平滑肌脂肪瘤的影像学诊断  

Imaging Diagnosis of Epithelioid Angiomyolipoma of Liver

作　　者：傅立平[1,2] 包迎伟[2] 纪建松[1] 赵中伟[1] 徐民[1] 王祖飞[1] 范晓希[1] 

机构地区：[1]丽水市中心医院放射科,浙江丽水323000 [2]浙江省遂昌县人民医院放射科

出　　处：《实用放射学杂志》2010年第7期973-976,共4页Journal of Practical Radiology

基　　金：丽水市科技局基金资助项目.

摘　　要：目的 研究肝上皮样血管平滑肌脂肪瘤的影像特征,以减少对该病的误诊.方法 对8例经手术病理证实为肝脏上皮样血管平滑肌脂肪瘤的临床及影像学资料进行回顾性分析.女6例,男2例,年龄56～68岁,平均62.5岁.7例肝上皮样血管平滑肌脂肪瘤行CT平扫及增强扫描,其中1例曾行MRI检查,1例仅行MRI检查.8例均误诊,其中4例术前误诊为肝癌（HCC）和肝血管瘤,3例误诊为局灶性结节增生（FNH）,1例误诊为血管肉瘤.结果 肝上皮样血管平滑肌脂肪瘤具有一定特征性的表现：（1）CT、MRI平扫呈等低、低或等高密度（信号）,边界光整,圆形或类圆形,大小约5～8 cm;（2）增强扫描动脉期呈明显或较明显均匀强化,少数可不均匀明显强化,中央或周边有明显强化的粗大畸形的血管;（3）强化方式为快进快出或快进慢出、持续性强化,仍有畸形血管可以辨别.结论 影像学结合临床资料对正确诊断肝脏上皮样血管平滑肌脂肪瘤有重要价值,少部分需要进行穿刺活检.Objective To study the imaging features of hepatic epithelioid angiomyolipoma（HEA）. Methods To clinical and imaging data of 8 cases with HEA proved by pathology were analysed retrospectively. There were 6 men and 2 women,age ranged from 56 to 68 years old, mean 62. $ years. Among these patients, 7 cases underwent plain and contrast--enhanced CT scan,MRI was done in one case simultaneously,and one case only underwent MRI. 8 cases were all misdiagnosed by imaging,including 4 cases misdiag- nosed as hepatic cell cancer（ HCC} ,3 cases misdiagnosed as focal nodular hyperplasia（FNH）, and 1 case as angiosarcoma. Results There were some distinct findings of HEA at imaging：（ 1）The lesions were iso--hypodense or hypodense（ signal）, well defined, round or round--like, 5 ~ 8 cm in diameters. （2）On contrast--enhanced scan, the lesions appeared as obviously homogeneous enhancement in artery phase, mostly and unhomogeneous enhancement in a few of cases, there were enlarged malformation vessels in the center or around the tumors. （23）The enhanced mode of the lesions appeared as quick--in and quick--out or quick--in and slow--out, and there were still malformation vessels could be identified. Conclusion The imaging findings of HEA in combination with clinical data is im- portant in making a correct diagnosis preoperatively,a few of HEA still have need biopsy to make final diagnosis.

关 键 词：肝脏 血管平滑肌脂肪瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]