肝上皮样血管平滑肌脂肪瘤和肝细胞肝癌的增强MR诊断  

Dynamic MR imaging diagnosis between hepatic epithelioid angiomyolipoma and hepatocellular carcinoma

作　　者：钱海峰[1] 林江 王青乐[2] 诸一吕[1] 张德生[1] 

机构地区：[1]湖州市中心医院放射科,浙江313000 [2]复旦大学附属中山医院放射科,上海200032

出　　处：《放射学实践》2012年第12期1339-1342,共4页Radiologic Practice

摘　　要：目的:探讨肝上皮样血管平滑肌脂肪瘤(EAML)和肝细胞肝癌(HCC)的MRI诊断和鉴别诊断。方法:回顾性分析经病理证实的9例肝EAML和24例HCC的MRI多时相动态增强的影像资料,对两组在病灶大小、部位、边界、增强模式、有无早期静脉引流、中心血管影、"假包膜"征及有无远端扩张胆管等方面的MR表现异同进行统计学分析。结果:9例肝脏EAML中8例显示早期引流静脉(8/9)、3例有"假包膜"征(3/9)、7例显示中心血管影(7/9)、9例均为"快进慢出"强化模式(9/9);而24例HCC中1例显示早期引流静脉(1/24)、18例有"假包膜"征(18/24)、3例显示中心血管影(3/24)、1例均为"快进慢出"强化模式(1/24)、23例为"快进快出"强化模式。两者在早期引流静脉、"假包膜"征、动脉期和(或)门脉期中心血管影显示及肿瘤的强化模式方面的差异有统计学意义(P<0.05)。结论:多时相动态增强MR有助于鉴别诊断肝EAML和HCC。Objective： To identify the dynamic MR imaging differences between hepatic epithelioid angiomyolipoma （EAML） and hepatocellular carcinoma （HCC）. Methods： The dynamic enhanced MR imaging materials of 9 cases with EAML and 24 cases with HCC proved by pathology were retrospectively analyzed. The differences of MR feathers in size, location,margin,enhancement pattern, early draining vein, central vessel, pseudocapsule and cholangiectasis were explored statistically. Results： On MRI,of 9 cases with EAML, 8 cases displayed early draining vein （8/9）, 3 cases displayed pseud- ocapsule （3/9）, 7 cases displayed central vessel （7/9）and all 9 cases displayed the dynamic enhancement pattern of ＂quick in and slow out＂ （9/9）. But in 24 cases with HCC, 1 case displayed early draining vein （1/24）, 18 cases displayed pseudocap- sule （18/24）, 3 cases displayed central vessel （3/24） and 1 case displayed the dynamic enhancement pattern of ＂quick in and slow out＂ （1/24）, the others displayed ＂quick in and quick out＂ （23/24）. It suggested that significant differences existed between hepatic EAML and HCC in displaying early draining vein,small vessels within or around hepatic tumors on arterial or portal phase and the dynamic enhancement pattern （P〈0.05）. Conclusion：The dynamic enhanced MR can be helpful to the diagnosis and differential diagnosis between hepatic EAML and HCC.

关 键 词：肝肿瘤 血管平滑肌脂肪瘤 癌 肝细胞 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]