摘要
目的:探讨肝脏血管平滑肌脂肪瘤的CT、MRI分型诊断价值及其病理基础。方法:收集经临床和病理资料证实的肝脏血管平滑肌脂肪瘤21例,分析其CT、MRI征象,探讨CT、MRI对各型的分型诊断价值及其病理基础。结果:21例均行CT扫描,其中12例行MR检查。血管瘤型4例,病理上以粗大扭曲的异常血管或血管瘤为主,CT、MR增强扫描异常血管或血管瘤动脉期呈明显强化,门脉期强化程度仍高于同期肝实质。肌瘤型3例,病理上以平滑肌成分为主,脂肪成分很少(<10%)。CT平扫为较均匀低密度,MRIT1WI呈低信号,T2WI呈稍高信号;CT、MRI增强扫描动脉期呈明显强化,门脉期、延迟期呈持续强化。脂肪瘤型5例,病理上以脂肪成分为主(≥70%),CT、MRI显示脂肪密度或信号。混合型9例,CT平扫为含有脂肪的混杂密度,MRIT1WI病灶主体呈不均匀低信号,脂肪成分呈高信号,T2WI呈混杂高信号,CT、MRI增强扫描其内软组织成分动脉期呈明显强化,门脉期仍有强化。病理上血管、平滑肌、脂肪3种成分比例接近(其中脂肪成分占10%～70%)。免疫组化:上述21例均显示HMB45(+)、SMA(+)。结论:CT、MRI能较好地反映肝脏血管平滑肌脂肪瘤的分型和各型的病理特征,具有一定的诊断特异性。
Purpose： To explore the classification diagnosis value and the pathological basis of hepatic angiomyolipoma（HAML） with CT and MR imaging features. Methods： The CT and MRI appearances of 21 patients with hepatic angiomyolipoma proved by pathology and clinical data were retrospectively analyzed. Results： All 21 patients were performed with helical CT scanning. Among of them, 12 patients were examined by MRI. （1） Angiomatous type （4 cases） ： Abnormal vessels were commonly seen in the lesions on pathology, which showed markedly enhancement in the early arterial phase and remained higher than the normal parenchyma in the portal phase on both CT and MR imaging features. （2） Myomatous type （3 cases）： The myomatous type was predominantly composed of leiomyoid cells mixed with small amount of adipocytes on pathology. Hypo - density on CT plain scanning and hypo - intensity on T1 weighted imaging, higher - intensity on T2 weighted imaging were seen in these lesions, after contrast administration, marked enhanced was seen during arterial phase and marked or moderate enhanced during portal or delayed phase. （3） Lipomatous type （6 cases） ： Lesions of the lipomatous type were mainly composed of adipocytes which could be easily recognized on both CT and MRI. （4）Mixed type （9 cases） ： Sheets of epithelioid muscle cells admixed with islands of adipocytes and abnormal vessels were in coincident proportion composed of in the lesions, and showing in- homogeneously density on plain CT scan, mainly low signal intensity and nodular fat signal on T1 weighted imaging, in - homogeneously high signal intensity on T2 weighted imaging. On dynamic study with both CT and MRI, the soft tissues exhibited obvious enhancement, which retained to some degree during the portal phase. The melanin marker HMB45 and muscle originated marker SMA were all positive in all cases on immunohistochemical stain,Conclusion： There are significant correlation between the classification and pathological basis of he
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2010年第4期316-321,共6页
Chinese Computed Medical Imaging
关键词
肝血管平滑肌脂肪瘤
CT
磁共振成像
Hepatic angiomyolipoma
X- ray computed, tomography
Magnetic resonance imaging
