非肝硬化背景下肝脏乏脂肪型血管平滑肌脂肪瘤的CT影像学表现、病理基础及鉴别诊断  

CT imaging features,pathological basis and differential diagnosis of fat-poor hepatic angiomyolipoma in the background of non-cirrhotic liver

作　　者：姜天娇[1] 户燕姣[2] 王家臣[1] 刘华秀 李伟[1] JIANG Tianjiao;HU Yanjiao;WANG Jiachen;LIU Huaxiu;LI Wei(Department of Radiology,the Affiliated Hospital of Qingdao University,Qingdao 266555,China;Department of Pathology,the Affiliated Hospital of Qingdao University,Qingdao 266555,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266555 [2]青岛大学附属医院病理科,山东青岛266555

出　　处：《医学影像学杂志》2024年第6期72-75,共4页Journal of Medical Imaging

摘　　要：目的探讨非肝硬化背景下乏脂肪型血管平滑肌脂肪瘤(fpHAML)的影像学特点,以提高对该类型病灶的认识。方法选取19例经病理证实的fpHAML患者的临床及影像学资料,所有患者均行CT平扫及动态增强检查。结果19例患者中16例(84.21%)无临床症状,3例(15.79%)仅有腹痛。患者均无肝炎、肝硬化和结节性硬化症的病史。19例患者中共20个病灶,所有病灶影像学表现均未见脂肪、钙化、出血、坏死及假包膜。所有病灶在动脉期显示出均匀/不均匀的明显强化,其强化程度明显高于周围正常的肝实质。8例门静脉期增强程度高于动脉期。病灶中可见多发的肿瘤血管,且直径大于3.0 cm的病灶更为常见。门静脉期或延迟期可见18个(90.00%)病灶的增强程度略高于或等于周围的正常肝实质。6个病灶(7.50%)显示存在早期引流静脉。10个(50.00%)病灶有强化范围逐渐增大的趋势。11个(55.00%)病灶显示血管样走行的延迟轻度强化区域。结论fpHAML的CT表现具有一定的特异性,有助于fpHAML的鉴别诊断。Objective To investigate imaging features of fat-poor hepatic angiomyolipoma(fpHAML)in non-cirrhotic livers in order to enhance the diagnostic accuracy of this condition.Methods Clinical and imaging data of 19 patients with pathologically confirmed fpHAML were retrospectively analyzed,and all patients underwent plain CT scan and dynamic enhancement examination.Results Among the 19 patients,16(84.21%)patients had no clinical symptoms.All patients had no history of hepatitis,liver cirrhosis and tuberous sclerosis.There were 20 lesions in 19 patients,and no macroscopic fat,calcification,hemorrhage,necrosis and tumor capsule were detected in 20 lesions.All the lesions showed even/uneven and marked enhancement on AP,and the degree of enhancement was significantly higher than that of adjacent hepatic parenchyma.In 8 cases,the enhancement of portal phase was higher than that of arterial phase.Multipleintra-tumor vessels could be seen in the tumor,and the lesions with diameter larger than 3.0cm were more common.The degree of enhancement of 18(90.00%)lesions on the portal phase(PP)or delayed phases(DP)was slightly higher than or equal to the surrounding normal liver parenchyma.Only 6(7.50%)cases showed the presence of early draining vein.10(50.00%)lesions had a tendency to increase the enhancement range.11(55.00%)lesions revealed vascular walk-like delayed mild enhancement area.Conclusion The CT features of fpHAML have certain specificity.As a result,an increased awareness of fpHAML is needed among radiologists.

关 键 词：肝脏 血管平滑肌脂肪瘤 体层摄影术 X线计算机 病理 

分 类 号：R737.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]