肝脏血管平滑肌脂肪瘤的影像表现及其与病理结果的对照分析  

Imaging manifestations of hepatic angiomyolipomas and analysis of pathological results

作　　者：谢辉[1] 高原智[1] 宿贝贝[1] 迟浩[1] 李真[1] 王华明[1] 

机构地区：[1]解放军第三○二医院影像中心,北京100039

出　　处：《肝脏》2013年第12期801-804,共4页Chinese Hepatology

摘　　要：目的探讨肝脏血管平滑肌脂肪瘤影像特征及其相关病理基础。方法回顾性分析经手术及活组织穿刺病理证实的9例肝脏血管平滑肌脂肪瘤患者资料,3例同时行CT及MR检查,6例仅行MR检查。评价所有患者的影像及病理结果,分析其相关性。结果 9例病灶均为单发。CT示病灶呈不均匀低密度影,病灶内含部分脂质成分。增强扫描:3例呈不均匀轻度强化,门脉期及延迟扫描呈不均匀密度影,病变脂肪部分呈低密度影,血管部分呈高密度影,2例见假包膜强化。MR示病变呈长T1稍长T2信号为主,4例T2信号不均匀,3例可见短T2流空信号,6例见大量脂质成分,2例病变内合并出血。8例行MR动态增强扫描,动脉期8例呈不均匀强化,强化程度为中到明显强化,门静脉期及延迟期扫描6例信号不均匀,3例以低信号为主,3例以高信号为主,4例见假包膜强化。MR增强动脉期3例同时可见粗大供血动脉及引流静脉,5例仅见粗大供血动脉,7例病灶内见扭曲血管影。结论肝脏血管平滑肌脂肪瘤的影像特征与其病理组织特征密切相关,最终确诊有赖于病理。Objective To explore the imaging manifestations of hepatic angiomyolipomas and its pathological results.Methods Nine patients with hepatic angiomyolipomas,who were confirmed by operation or biopsy pathology, were retrospectively analyzed.Three cases underwent CT and MR examination simultaneously,other 6 cases underwent MR examination alone.The correlation of imaging manifestations and pathological results of all the patients were analyzed.Results All the lesions of the 9 patients were single,CT scan showed that lesions were unevenly low density, and the value of CT showed that lesions contained lipid composition.Enhanced CT scan showed that 3 cases presented unevenly mild reinforcement,portal phase and delayed scan showed uneven density with fat part of the lesions as low density and vascular section as high density,and reinforcement of pseudocapsule in 2 cases was also observed.MR scan showed a longer T1 and a litter longer T2 signal,T2 signals of 4 cases were uneven,short T2 flow void signal was observed in 3 cases,a lot of lipid composition was in 6 cases,and bleeding lesions were in 2 cases.Dynamic enhanced MR scan was performed in 8 cases.In arterial phase,moderately to significantly uneven reinforcement was observed in all patients.In portal venous phase and delayed phase,scanning signal was uneven in 6 cases,low signal was in 3 cases, high signal was in 3 cases,and pseudocapsule reinforcement was observed in 4 cases.In arterial phase of enhanced MR scan,feeding arteries and draining veins were observed simultaneously in 3 cases,only feeding arteries in 5 cases, distorted blood vessels in 7 cases.Conclusion The imaging manifestations of hepatic angiomyolipomas are closely related to its pathological features,while the ultimate diagnosis still depends on pathology.

关 键 词：肝脏平滑肌脂肪瘤 影像诊断 病理学 对比分析 

分 类 号：R735.7[医药卫生—肿瘤]