肝腺瘤的MRI及MSCT诊断  

MRI and MSCT Diagnosis of Hepatocellular Adenoma

作　　者：杨燕[1] 郑继坤[1] 孟娴[1] 黄伟[1] 姜曼 刘兴华[2] YANG Yan;Zheng Jikun;Men Xian(Department of Radiology,First Affiliated Hospital,Yunnan University of TCM,Kunmin 650021,P.R.China)

机构地区：[1]云南省中医医院/云南中医学院第一附属医院放射科,昆明650021 [2]重庆三峡中心医院医学影像科,404100

出　　处：《临床放射学杂志》2018年第9期1488-1491,共4页Journal of Clinical Radiology

摘　　要：目的探讨MRI及多层螺旋CT（MSCT）检查对肝腺瘤（HCA）的诊断及鉴别诊断价值。方法回顾性分析经病理确诊的13例HCA患者的影像（MRI、MSCT）资料,包括病灶的部位、大小、形态、数目、边界、强化特点、表观扩散系数（ADC）值、是否有脂肪/脂质、出血、坏死、假包膜等。结果 13例中1例为2个病灶,其余单发,共14个病灶。病灶在T1WI呈低或稍低信号10个,稍高信号3个,混杂信号（稍低信号为主）1个。T2WI呈高信号9个,低信号4个,混杂信号1个。扩散加权成像（DWI）呈稍高信号10个,等信号4个。MSCT均匀稍低密度6个,不均匀稍低密度5个,不均匀低密度2个,等密度1个。DWI扫描测量病灶的ADC值为（1.693±0.241）×10^-3mm^2/s,邻近正常肝实质为（1.343±0.241）×10^-3mm^2/s,两者ADC比值〉1。增强后动脉期病灶明显强化14个。门静脉期呈稍高信号9个,稍低信号5个。平衡期呈低信号10个,4个为等信号。28.6%（4/14）病灶见假包膜。14.3%（2/14）病灶内含脂肪/脂质。14.3%（2/14）灶内出血。21.4%（3/14）见缺血坏死。结论 MRI、MSCT检查及动态增强扫描能较准确地诊断HCA。Objective To explore the diagnosis and differential diagnosis value of magnetic resonance imaging（ MRI）and multi-slice spiral CT（ MSCT） scan in hepatocellular adenoma（ HCA）. Methods The MRI and MSCT imaging manifestations of 13 patients with HCA confirmed pathologically were analyzed retrospectively. Image analysis included the following： lesion location,maximum size,morphology,number,border,enhancement characteristics,ADC value and so on,fat、steatosis,presence of hemorrhagic,necrosis,pseudocapsule. Results In 13 cases of HCA,two lesions were present in 1 case,single lesion was in 12 cases,with 14 lesions in total. On T1WI,10 lesions showed hypointensity or slight hypointensity,3 lesions showed slight hyperintensity,1 lesion showed mixed signal（ hypointensity signal-based）. On T2WI,9 lesions showed hyperintensity,4 lesions showed hypointensity,1 lesion showed mixed signal. On diffusion weighted imaging（ DWI）,10 lesions showed slight hyperintensity,4 lesions showed isointensity. On MSCT 6 lesions showed slightly uniform density,5 lesions showed slightly uneven density,2 lesions showed uneven density,1 lesion showed equal density. On DWI,the mean apparent diffusion coefficient（ ADC） value was（ 1. 693 ± 0. 241） × 10^-3mm^2/s,with a total of 14 lesions. The ADC value of the surrounding normal liver parenchyma was（ 1. 343 ± 0. 241） × 10^-3mm^2/s,with the ratio of lesion to surrounding normal liver parenchyma 1. 14 lesions showed marked enhancement in arterial phase. 9 lesions showed slight hyperintensity,5 lesions showed slight hypointensity in the venous phase. 10 lesions showed hypointensity,4 lesions showed isointensity in equilibrium phase. 4 lesions showed pseudocapsule（ 28. 6%）. 2 lesions contained fat or steatosis（ 14. 3%）. 2 lesions showed intralesional hemorrhage（ 14. 3%）. 3 lesions showed necrosis（ 21. 4%）. Conclusion MRI,MSCT scans and dynamic contrast-enhanced scans can diagnose hepatocellular adenoma accurately.

关 键 词：肝肿瘤 腺瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44