肝腺瘤的CT诊断和鉴别诊断

CT Signs and Differential Diagnosis of Hepatic Adenoma

目的:观察肝腺瘤的CT表现,总结其具有诊断意义的影像学特征。方法:分析经病理证实的7例肝腺瘤CT图像,对病灶的平扫及增强扫描进行观察。结果:平扫:7例均为单发肿块,直径3.5-7.5cm,平均5.5cm。3例见稍低密度包膜影,3例见不完整包膜。3例表现稍低密度背景下间杂片状高密度出血灶。增强扫描:动脉期5个病灶中度强化,门脉期持续强化,延迟期呈等或略高密度,可见假包膜。2例呈类似肝癌的速升速降型强化,但其强化程度不如肝癌迅速。平扫时病灶内高密度区域,增强扫描三期均无明显强化。包膜的强化大部呈延时强化的趋势。结论:肝腺瘤在CT扫描中有一定特征。准确把握其影像学表现,可以大大提高诊断的准确率。

Objective： To observe CT findings of hepatic adenomas and to conclude the characteristic imagingfeatures. Methods To retrospectively investigate CT imaging features of 7 hepatic adenomas which had been confirmed by pathologic biopsy, both plain CT scan and enhanced CT scan imagings were involved. Results： Plain CT scan： All 7 lesions were solitary masses, the diameter ranged from 3.5 to 7.5cm, with a mean of 5.5 cm. 3 lesions showed slightly hypo-dense capsules, the other 3 lesions showed discontinuous capsules. Meanwhile, 3 lesions showed slightly hypo-dense background mixing with patchy hemorrage areas which demonstrated hyper-density. Enhanced CT scan： 5 lesions enhanced moderately in arterial phase, and gradually enhanced in portal phase, in delayed phase these lesions demonstrated iso-density or slightly hyper-density, the pseudocapsule also could be seen. The enhancement behaviors of 2 lesions were similar to hepatocellular carcinoma （HCC）, but the degree of enhancement was not so fast as HCC. The hyper-dense areas within lesions in plain CT scan showed no obvious enhancement in triple-enhancement phase. Most capsules demonstrated the trend of delayed enhancement. Conslusions： Hepatic adenomas have some characteristic features in CT imagings, by grasping these features exactly, the accuracy of diganosis of hepatic adenomas can be greatly improved.