肝血管平滑肌脂肪瘤的CT表现与病理对照分析

Contrast Analyse of CT Imaging Findings and Pathology in Hepatic Angiomyolipoma

目的探讨肝脏血管平滑肌脂肪瘤(HAML)的CT表现特征以提高术前确诊率。方法回顾性分析12例经病理证实为HAML的临床、病理和CT表现特征。记录病灶部位、大小、边缘、密度、血运和强化特征。结果HAML病灶表现为边界清楚、孤立性的肿块。12例患者中,8例病灶中可见脂肪,1例伴有钙化,1例可见囊性变;动脉期CT值超过120Hu 11例(91.7%);出现外周强化逐渐降低和动脉期肝静脉早显的患者均为10例(83.3%);未见肝硬化和逐渐强化的假包膜。结论 CT上表现为富血供、动脉期肝静脉早期显影、外周强化逐渐降低,无假包膜是HAML与肝癌的重要鉴别点。

Objective To evaluate the computed tomography （CT） findings of hepatic angiomyolipoma （HAML） and to improve the diagnostic efficacy of the tumor. Methods Clinical characteristics, pathology, and CT imaging findings were retrospectively evaluated in 12 patients with HAML. All the patients underwent CT with unenhanced and contrast-enhanced examinations. Imaging characteristics, such as the lesion location, lesion diameter, presence of early draining veins and enhancement pattern were reviewed. Results HAML was seen as a well-defined, solitary mass on CT imaging. Fat was detected in eight patients. Calcification was noted in one patients and cystic degeneration was seen in one patient. The mean attenuation values exceeded 120 hounsfield units （Hu） in 11 patients （91.7%）. Peripherally decreasing enhancement rim or early draining vein was seen in 10 patients （83.3%）. The early draining veins were all hepatic veins. Hepatic cirrhosis and capsule were not detected in all patients. Conclusion The presence of early draining vein, peripheral decreasing enhancement rim, and the absence of tumor capsule may be helpful for the diagnosis of HAML.