肝脏上皮样血管平滑肌脂肪瘤的MSCT表现  

Hepatic Epithelioid Angiomyolipoma MSCT Fingdings

作　　者：吴若岱 杨旭峰[2] 王猛[2] 周丽莎[2] 黄坤[2] 方壮念 郑可国[2] 冯仕庭[2] 

机构地区：[1]深圳市宝安区中心医院放射科,深圳518000 [2]中山大学附属第一医院放射科,广州510080

出　　处：《临床放射学杂志》2016年第3期395-398,共4页Journal of Clinical Radiology

摘　　要：目的探讨肝脏上皮样血管平滑肌脂肪瘤(HEAML)的MSCT表现。方法搜集经手术后病理证实的8例HEAML患者的64层MSCT平扫及双期增强扫描资料,回顾性分析其CT表现,并与病理结果相对照。结果 8例均为女性,7例单发,1例多发。8例CT平扫均呈低密度结节或肿块,未见脂肪密度;增强扫描:7例动脉期明显不均匀强化,病灶内部或边缘见粗大的畸形血管影,强化程度接近腹主动脉,门脉期强化程度低于周围肝实质,呈"快进快出"表现,粗大畸形的血管仍持续强化;1例动脉期全瘤明显强化,门脉期强化程度与正常肝实质相近,呈"快进慢出"表现,病灶周边可见畸形血管影,强化程度低于腹主动脉。7例可见不同程度的引流静脉早期显影。6例可见假包膜,动脉期及门脉期均强化。结论 HEAML的MSCT表现有一定的特征性,病灶内部或边缘出现粗大畸形的静脉有助于该病的诊断。Objective To investigate the MSCT characteristics of Hepatic Epithelioid Angiomyolipoma （HEAML）. Methods The CT data of 8 cases of HEAML confirmed by postoperative pathology were retrospectively analysised and compared with the ppathological results. Results All the 8 cases were female and in which 7 cases were solitary while 1 case was multiple. All the 8 cases took the form of nodule or mass of low intensity with absence of adipose intensity, cCon- trast-enhanced CT scanning： 7 cases which had the enhancement mode of quick wash-in and quick wash-out showed markedly heterogeneous enhancement in arterial phase, large malformed vessels with the enhancement similar to the abdom- inal aorta also could be identified in the center of or around the lesions , and in portal phase, the lesions appeared hypoin- tense compared with adjacent normal enhanced liver parenchyma, and large malformed vessels showed continuous enhance- ment . 1 case which had the enhancement mode of quick wash-in and slow wash-out showed marked enhancement in the whole lesion in arterial phase and isodensity with adjacent liver parenchyma in portal phase, malformed vessels with the en- hancement lower than the abdominal aorta also could be found around the lesion. 7 cases showed various degrees of early enhancing draining veins. 6 cases showed pseudoeapsule sign which enhanced both in arterial and portal phases. Conclu- sion The MSCT features of HEAML have characteristic, large malformed vessels in the center or around the lesion could contribute to establishment of proper diagnosis.

关 键 词：肝脏 上皮样 血管平滑肌脂肪瘤 多层螺旋CT 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]