肝脏上皮样血管平滑肌脂肪瘤的MRI表现  

MRI diagnosis of epithelioid angiomyolipoma of liver

作　　者：王昭华[1] 吴东[2] 侯君[2] 张立涛[3] 孔庆奎[3] 

机构地区：[1]上海复旦大学附属中山医院放射诊断科, 200032 [2]上海复旦大学附属中山医院病理科,200032 [3]泰安市中心医院影像科

出　　处：《中华放射学杂志》2012年第9期803-806,共4页Chinese Journal of Radiology

摘　　要：目的探讨肝脏上皮样血管平滑肌脂肪瘤（EAML）的MRI表现。方法回顾性分析2010年6月至2011年7月经手术病理及免疫组织化学证实的8例肝脏EAML患者资料，分析其影像特点，包括病灶的分布、信号强度、血供、病灶内的血管、病灶的供血动脉和引流静脉、脂肪、出血和坏死囊变的存在以及假包膜等，并与病理结果对照。结果8例患者均为单发病变，呈长T1、长T2信号，DWI为高信号，6例T2WI信号不均匀，其中1例见少量脂肪，3例合并出血。MR动态增强扫描，动脉期8例均呈中度或明显强化，其中6例强化不均匀，2例均匀，门静脉期及延迟期病灶强化程度有所减退，但信号仍高或稍高于周围肝实质。MR增强动脉期4例同时可见粗大供血动脉及引流静脉，1例仅见引流静脉，1例仅见粗大供血动脉。7例病灶内见扭曲血管影。结论MR检查可显示肝脏EAML的影像特征，病灶的供血动脉和引流静脉以及病变内扭曲血管影的显示有助于肝脏EAML的诊断和鉴别诊断。Objective To retrospectively analyze the MRI findings of epithelioid angiomyolipoma （EAML） of the liver. Methods The MR findings in a series of 8 patients with pathologically proven liver EAML were retrospectively analyzed. Distribution of lesions, signal intensity characteristics, tumor vascularity, feeding arteries and draining veins, fat, hemorrhage, cystic necrosis and pseudocapsule formation were evaluated and correlated with pathology. Results A single lesion was found in each of the 8 patients. All eight lesions showed long T1, long T2 inhomogeneous signal, and high DWI signal. There was only 1 lesion presented with fat, 3 lesions presented with hemorrhage. On the dynamic contrast- enhanced MRI scan, all 8 lesions manifested as hypervascular with tortuous vasculature in 7 patients. Dilated feeding arteries and draining veins were seen in 5 patients. Conclusion Liver EAML has unique MR imaging features, exhibiting hypervaseular lesions with dialated, tortuous feeding arteries, and draining veins on DCE MRI, which could be helpful in the differential diagnosis of liver EAML.

关 键 词：肝肿瘤 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]