肝脏血管平滑肌脂肪瘤的CT表现  

CT appearances of hepatic angiomyolipoma(HAML)

作　　者：汪国余[1] 陈再智[1] 徐祖良 吴玉林[1] 

机构地区：[1]台州市中心医院影像中心,浙江318000

出　　处：《影像诊断与介入放射学》2011年第5期350-353,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨肝脏血管平滑肌脂肪瘤(HAML)的CT特征及诊断价值,提高对其诊断的准确率。方法回顾性分析12例经手术病理证实HAML的各期CT表现,其中8例动脉期、门脉期加做薄层CT扫描,5例加做MRP、MIP、VR等后处理技术。结果 12例中女性10例,右肝7例,左肝5例,其中2例呈外生性。CT平扫12个病灶皆为低密度,7例病灶密度不均匀,都测到脂肪密度,CT值小于-20HU,增强扫描7个病灶呈团、片状明显强化,门脉期病灶持续强化,延迟期病灶强化程度减低。5例密度均匀,1例完全为脂肪密度,CT值-54HU左右,增强扫描无明显强化,4例为软组织密度,增强扫描动脉期强化明显,门脉期持续强化,延迟期1例为等密度,3例为相对低密度。动脉期和/或门脉期共有5例病灶内见中心血管影,其中1例引流至肝静脉内。结论虽然因组织成分不同HAML的CT表现差异大,但只要把握特征性影像学征象,就有助于提高术前诊断率。Objective To study the imaging features of hepatic angiomyolipoma （HAML） on CT so as to improve the diagnostic accuracy. Methods CT findings of 12 cases with pathologically-proved hepatic angiomyolipoma were retrospectively summarized and analyzed, additional thin slice scan was done on arterial phase and portal phase in 8 cases, multi-planar reconstruction （MPR）, maximum intensity projection （MIP） and volume rendering technique （VR） were carried out in 5 cases. Results Of the 12 patients, 10 were female. 7 lesions were located in right hepatic lobe, 5 were in left hepatic lobe, in which 2 lesions outgrew from hepatic lobe. 12 lesions appeared as hypo-density on pre- contrast CT scan. The first group consisted of 7 lesions with inhomogeneous density and fat density, which could be measured with CT values〈-20HU. The soft tissue component of the 7 lesions were markedly and unevenly enhanced on arterial phase and continued on portal phase. Then the density reduced on parenchymal phase. The second group consisted of 5 lesions with homogeneous density. One lesions was fat density with CT values of -54HU without marked enhancement on contrast scanning. Most part of the other 4 lesions were soft tissue density with markedly enhanced on arterial phase and continuously enhanced on portal phase, equidensity in 1 lesion and low density in the other 3 lesions on parenchymal phase. The central vascular structure could be seen in 5 lesions on arterial phase and/or portal phase, and one of that led into hepatic vein. Conclusion Although the CT appearances of HAML showed with different components of the tumor, it will be helpful to improve the diagnostic accuracy before surgery if the characteristic CT appearances of HAML were accurately grasped.

关 键 词：血管平滑肌脂肪瘤 肝脏 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]