肝腺瘤的影像学表现分析

Imaging Diagnosis of Hepatocellular Adenomas

目的分析肝腺瘤的CT、MRI及超声表现,以提高诊断准确率。方法回顾性分析7例经术后病理证实的肝腺瘤患者的术前影像学资料,包括超声、CT及MRI平扫加增强检查。结果 CT平扫较均匀等密度3例,稍低密度2例,合并出血呈混杂密度2例,边界不清;MRI平扫T1WI均呈不均匀高信号,压脂序列信号变化不明显,T2WI为不均匀中高信号;增强动脉期较均匀明显强化5例(出血区无强化),不均匀中等强化2例,门脉期略有下降,延迟期呈等密度。4例可显示假包膜轻度强化。彩超均为实性低回声肿块,边界清楚,形态规则,周围无声晕,多普勒病灶周边及内部见较丰富的门脉样血流及低速动脉样血流2例。结论 CT及MRI增强检查对肝腺瘤的诊断价值较大,MRI显示特征性表现优于CT。

Objective To improve the capability of diagnosis by investigating the hepatocellular adenoma （HA） features of CT, MRI and ultrasonographic presentations .Methods The imaging findings were retrospectively analyzed of 7 patients with histopathologi-cally proven HA, including the features of ultrasound, CT, MRI plain scan and enhanced scans.Results 3 cases on CT plain scan showed the isodensity, 2 cases with slightly lower density, 2 cases with parenchyma miscellaneous density, not obviously distinguishing the normal liver.5 cases showed enhanced scan arterial phase, 2 cases showed inhomogeneous medium arterial phase enhancement, portal phase dropping slightly, and the delayed phase and liver parenchyma showed isodensity.MRI scanned T1WI displayed inhomogeneous high signal and fat saturation scan TIWI did not change obviously.T2WI showed irregular slightly high signal.The dynamic enhanced MRI and enhanced CT showed similarity.4 cases displayed pseudointegument and slight enhancement, while all showed echogenicity sol-id mass, with clear bouldery and shape, no halo sign examined by color Doppler ultrasonography （ CDU ）.2 cases had abundance of ar-terial and venous flow in the peripheral and internal lesion.Conclusions CT and MRI enhanced examination is significant for the diag-nosis of hepatocellular adenoma, and MRI was superior to CT in manifesting the feature of the hepatocellular adenomas.