乏脂肪型肝脏血管平滑肌脂肪瘤CT和MRI表现分析及鉴别诊断文献复习  

Analyzing Imaging Features of Hepatic Angiomyolipoma Devoid of Fat for Diagnosis and Differential Diagnosis: A Retrospective Study with Literature Review

作　　者：江海涛[1] 刘璐璐[2] 郑国华[1] 阮磊 邵国良[1] 朱慧能[1] 苏影[1] JIANG Hai-tao;LIU Lu-lu;ZHENG Guo-hua(Zhejiang Cancer Hospital, Hangzhou 310022, China;Zhejiang Chinese Medical University, H angzhou 310053, China)

机构地区：[1]浙江省肿瘤医院,浙江杭州310022 [2]浙江中医药大学,浙江杭州310053

出　　处：《肿瘤学杂志》2018年第3期235-239,共5页Journal of Chinese Oncology

基　　金：浙江省自然科学基金(LQ17H180003)

摘　　要：[目的]探讨影像学上表现为乏脂肪型的肝脏血管平滑肌脂肪瘤（hepatic angiomyolipoma,HAML）的CT和MRI表现并复习文献,旨在提高对该病的认识和诊断准确性。[方法 ]回顾性分析经穿刺或者手术病理证实的6例乏脂肪型HAML的CT和MRI表现及临床资料。[结果 ]6例HAML均为女性,4例位于肝右叶,2例位于肝左叶。6例HAML均单发,边界清楚。CT平扫呈稍低密度,密度均匀,平扫均未见条状及裂隙状脂肪密度影,增强扫描动脉期肿瘤呈均匀明显强化,门脉期强化明显减退;MRI平扫T1WI呈稍低信号,T2WI呈稍高信号,正反相位未见明显信号改变,DWI及ADC均呈高信号。增强扫描动脉期肿瘤均匀明显强化,门脉期强化明显减退。6例增强模式均为＂快进快出＂型。6例病灶均可见粗大强化的血管穿行于病灶或者在病灶周围。6例病灶内均未见坏死、囊变、钙化及假包膜。[结论]HAML的影像学表现具有一定的特征性,了解这些影像特征能够提高该病术前诊断的正确率。[Objective]To evaluate the imaging features of hepatic angiomyolipoma（HAML）devoid of fat so as to improve the understanding and diagnostic accuracy of this disease.[Methods]The clinical data,including computed tomography（CT）and magnetic resonance imaging（MRI）records,of 6 patients with pathologically confirmed HAML devoid of fat were reviewed and analyzed with literature review.[Results]Of the 6 patients,all were female;4 had lesions located in the right lobe of liver,and 2 had lesions located in the left lobe of liver.All patients had solitary lesions with well-defined boundaries.Non-enhanced CT images showed lesions with slightly low density.There was no limited spot-or arc-like low density in the center or on the edge of lesions with CT values of-30 to-10 HU.Two cases showed slightly low-signal intensity on T1 WI and slightly high-signal intensity on T2 WI.There were no obvious signal changes on inphase images,and low-signal intensity was observed on out-phase images.Both DWI and ADC showed high-signal intensity.Contrast-enhanced CT and MRI showed signal enhancement with"fast in and slow out" fashion in the arterial phase,obvious signal decrease in the portal phase,and signals of blood vessels crossing or surrounding lesions in all cases.No necrosis,cystic change,calcification,and pseudocapsule were found in 6 cases.[Conclusion]HAML devoid of fat has certain characteristic imaging manifestations,which can improve the accuracy of preoperative diagnosis of the disease.

关 键 词：肝脏血管平滑肌脂肪瘤 CT MRI 鉴别诊断 

分 类 号：R730.262[医药卫生—肿瘤]