肝脏异位肾上腺腺瘤3例并文献复习  

Three cases with ectopic adrenal adenoma in liver and literature review

作　　者：刘林成 张宝伟 安超 李建龙[1] 赵梦龙 赵记明[1] LIU Lincheng;ZHANG Baowei;AN Chao;LI Jianlong;ZHAO Menglong;ZHAO Jiming(Department of Radiology,People’s Hosipital of Rizhao,Rizhao 276800,China;Department of Ultrasound,People’s Hospital of Rizhao;Department of Radiology,Zhongshan Hospital,Fudan University,Department of Radiology,Shanghai Geriatric Medical Center)

机构地区：[1]日照市人民医院医学影像科,日照276800 [2]日照市人民医院超声科 [3]复旦大学附属中山医院放射科上海市老年医学中心放射科

出　　处：《国际医学放射学杂志》2024年第5期614-618,共5页International Journal of Medical Radiology

摘　　要：目的分析归纳3例肝脏异位肾上腺腺瘤的临床特点及影像学表现,以提高对该病的认识。方法回顾性分析3例经手术病理证实的肝脏异位肾上腺腺瘤病人的临床及影像资料,并复习相关文献。结果3例病变均位于肝右叶包膜下Ⅶ段,肿瘤呈单发。CT表现为圆形或椭圆形低密度肿块影。MRI表现为T_(1)WI同相位稍低信号,反相位信号明显减低,T_(2)WI稍高信号;DWI扩散受限;增强扫描动脉期明显不均匀强化,静脉期及延迟期病灶局部呈相对低信号,呈“快进快出”强化方式,1例延迟期见包膜样强化。3例均有脂肪变性。结论肝脏异位肾上腺腺瘤的临床表现、发病部位及影像学特征有一定的特点,结合临床、影像学特征有助于对该病诊断。Objective To analyze and summarize the clinical and radiological characteristics of 3 patients with ectopic adrenal adenoma in liver,in order to improve the understanding of this disease.Methods The data of 3 patients with hepatic ectopic adrenal adenoma confirmed by pathology were retrospectively analyzed,and relevant literatures were reviewed.Results The lesions of 3 cases were all located in segmentⅦ,subcapsular to the right lobe of the liver,and presented as solitary nodules.CT showed round or oval hypodense masses.MRI showed slightly hypointense on T_(1)WI in-phase,significantly decreased signal on out-of-phase,slightly hyperintense on T_(2)WI,and restricted diffusion on DWI.On enhanced MRI scans,the lesions showed marked heterogeneous enhancement in the arterial phase,and relative hypoattenuation in the portal venous and delayed phases,presenting a“wash-in,wash-out”pattern.One case showed capsular enhancement in the delayed phase.All three cases showed intracellular steatosis.Conclusions Ectopic adrenal adenoma of the liver has distinct clinical manifestations,locations,and imaging features.A combination of clinical and imaging findings is helpful for the diagnosis of this disease.

关 键 词：肝脏 异位肾上腺腺瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R816.5[医药卫生—放射医学] R445.2[医药卫生—临床医学]