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 back-ground of non-cirrhotic liver
姜天娇 1户燕姣 2王家臣 1刘华秀 1李伟1
作者信息
- 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
- 折叠
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.
Abstract
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 pathologi-cally confirmed fpHAML were retrospectively analyzed,and all patients underwent plain CT scan and dynamic enhancement ex-amination.Results Among the 19 patients,16(84.21%)patients had no clinical symptoms.All patients had no history of hepa-titis,liver cirrhosis and tuberous sclerosis.There were 20 lesions in 19 patients,and no macroscopic fat,calcification,hemor-rhage,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 enhance-ment of portal phase was higher than that of arterial phase.Multipleintra-tumor vessels could be seen in the tumor,and the le-sions 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Key words
Liver/Angiomyolipoma/Tomography,X-ray computed/Pathology引用本文复制引用
出版年
2024
NETL
NSTL
万方数据