肝脏上皮样血管平滑肌脂肪瘤的MRI表现  

MRI features of hepatic epithelioid angiomyolipoma

作　　者：何莎莎[1] 王青乐 周旭峰[1] HE Shasha;WANG Qingle;ZHOU Xufeng(Department of Radiology,Zhongshan Hospital of Fudan University,Shanghai 200032,China)

机构地区：[1]河南省洛阳市中心医院医学影像科,河南洛阳471000 [2]复旦大学附属中山医院放射科,上海200032

出　　处：《中国中西医结合影像学杂志》2021年第1期65-68,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨肝脏上皮样血管平滑肌脂肪瘤(HEAML)的MRI特征。方法:回顾性分析经病理证实的47例HEAML的MRI平扫及增强扫描资料,其中7例另行钆塞酸二钠增强扫描,并与病理对照。结果:47例共54个病灶,43例(91.5%)单发,4例(8.5%)多发(1例2个,3例3个);位于肝右叶21个(38.9%),左叶29个(53.7%),尾状叶4个(7.4%);最大径0.7~8.6 cm,平均5.3 cm。T1WI呈低信号,T2WI呈高信号,13个(24.1%)病灶内见少量脂肪组织;DWI呈高信号,ADC值(1.6197±0.4652)×10^-3 mm^2/s。增强扫描动脉期全瘤明显强化25个(46.3%),边缘结节样强化17个(31.5%),内部分隔样强化12个(22.2%);强化方式为速升缓降型18个(33.3%),速升速降型15个(27.8%),缓慢持续强化21个(38.9%);37个(68.5%)病灶内部见条形、斑点样强化血管影,42个(77.8%)病灶周边见粗大静脉;5个(9.3%)病灶周边见不连续包膜样强化;7例10个(18.5%)病灶肝胆期均呈低信号。结论:HEAML中年女性多见,MRI表现具有一定特征,增强扫描动脉早期病灶多明显强化,后期强化减退但仍高于肝实质,中心见血管影、周边见引流静脉及无包膜均是重要征象,此外钆塞酸二钠增强扫描后肝胆期病灶均呈低信号。Objective:To investigate the MRI features of hepatic epithelioid angiomyolipoma.Methods:The MRI data of 47 patients with hepatic epithelioid angiomyolipoma were analyzed and compared with pathology results retrospectively,7 cases of them were enhanced by Disodium gadolinium selenate.Results:There were 54 lesions in 47 cases,43 cases(91.5%)were single,4 cases were multiple(1 case of 2 lesions,3 cases of 3 lesions).21 lesions were located in the right lobe of the liver(38.9%),29(53.7%)in the left lobe,and 4 in the caudate lobes(7.4%).The lesions showed low signal on T1WI,high signal on T2WI,and a small amount of fat tissue in 13 lesions;high signal on DWI.ADC value was(1.6197±0.4652)×10^-3 mm^2/s.25 lesions were with arterial enhanced type(46.3%),17 nodular enhanced types(31.5%),and 12 internal partitions enhancement(22.2%).The way of enhancement in 18 lesions was rapid increase and slow decrease,15 lesions showed rapid increase and rapid decrease,and 21 lesions were slow and continuous strengthening.37(68.5%)lesions had strip and spot-like enhanced blood vessel shadows,and 42(77.8%)lesions had thick veins around;discontinuous envelope-like enhancement were seen around 5 lesions;10 lesions of 7 cases showed low signal in hepatobiliary phase.Conclusions:The MRI of hepatic epithelioid angiomyolipoma has certain characteristics.Middle aged women are more common.Lesion is significantly enhanced in the early stage of arterial phase,and the regression in the later stage is still higher than that of the liver parenchyma.The vascular shadow is seen in the center.The indication of draining vein and no capsule is an important sign.And the lesions show hypointense in hepatobiliary phase.

关 键 词：肝肿瘤 血管肌脂瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]