肝脏血管平滑肌脂肪瘤的影像表现及误诊分析  

Image Features and Misdiagnosis Analysis of Hepatic Angiomyolipoma

作　　者：封俊[1] 高德培[1] 谭静[1] 廖承德[1] 杨光军[1] 李振辉[1] 

机构地区：[1]昆明医科大学第三附属医院,云南省肿瘤医院,云南昆明650118

出　　处：《昆明医科大学学报》2015年第11期99-103,共5页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81260408)

摘　　要：目的探讨肝脏血管平滑肌脂肪瘤的影像表现,提高对本病的认识及术前诊断能力.方法回顾性分析昆明医科大学第三附属医院6例经手术病理证实的肝脏血管平滑肌脂肪瘤影像表现及其临床病理资料,分析影像表现及病理特点,总结误诊原因.结果 6例均为单发病灶,其中4例病灶密度或信号不均,其内见脂肪密度或信号,2例密度均匀,未见脂肪成分;增强扫描动脉期6例病灶呈明显强化,其中4例病灶内出现中心血管影,门脉期实质期呈持续强化;上述病例均无肝硬化征象,其中1例女性患者乙肝病史5 a,余5例患者均未有相关肝病病史.结论肝脏血管平滑肌脂肪瘤临床少见,易误诊.病灶内检出脂肪成分,增强呈快进慢出或持续性强化,见中心血管影,无肝硬化表现及慢性肝病史,有助于诊断本病.Objective To investigate the imaging features of Hepatic angiomyolipoma and to improve the diagnosis capabilities.Methods The image features of 6 cases of hepatic angiomyolipoma confirmed by operation and pathology were retrospectively studied and the image and pathology features were analyzed so as to summe up the reason of misdiagnosis.Results The lesions were single in 6 cases.The tumors showed uneven density（n=4）,even density（n =2）, 4 tumors were clearly seen with fat density shadow.On the arterial phase scanning, all lesions showed enhancement, and obvious thickened vessels shadow could be seen in 4 lesions.On the portal venous phase,4 lesions continued to strengthen.All cases had no features of cirrhosis of liver.One case was with viral hepatitis type B history, the other 5 cases had no hepatic disease history.Conclusion Hepatic angiomyolipoma is rare, maybe misdiagnosed.The presence of fat content and thickened vascular structure is the pathognomonic signs of hepatic angiomyolipomas.Early enhancement with different degrees of continued enhancement pattern is helpful for the diagnosis.

关 键 词：肝脏 血管平滑肌脂肪瘤 体层摄影术 螺旋计算机 磁共振成像 超声 误诊 

分 类 号：R332[医药卫生—人体生理学]