肝细胞腺瘤的MRI诊断价值

The Diagnostic Value of MRI for Hepatocellular Adenoma

目的探讨MRI对肝细胞腺瘤(hepatocellular adenoma,HCA)的诊断价值。方法回顾性分析9例经病理证实的HCA的MRI检查资料,均行MRI平扫及动态增强扫描。结果 1病灶圆形或类圆形,边界清晰;肝右叶6例,左叶3例,平均直径5.2cm。5例肿块内有出血;7例有包膜。2MRI征象:7例T1WI同相位呈低或等信号,反相位均见条或片状信号减低;抑脂T2WI呈稍高或高低混杂信号;DWI呈稍高信号;动态增强动脉期均明显强化,门静脉期不同程度强化,延迟期4呈稍高信号,1例呈等信号,2例呈稍低信号。2例T1WI同相位呈等或稍高信号,T1WI反相位片状信号减低;抑脂T2WI呈稍低或等信号;DWI呈稍低信号;动态增强1例动脉期中度强化,1例轻度强化,门静脉期均持续强化,延迟期呈稍低信号。7例有包膜并延迟强化。结论 MRI检查能准确显示HCA的组织结构,具有一定的特征,可以提高与肝内含脂病变的鉴别诊断,在术前做出正确诊断。

Objective To investigate MRI value in diagnosing hepatocellular adenoma （HCA）. Methods MRI findings of 9 cases with HCA proved by pathology were analyzed retrospectively. All were performed MRI plain and dynamic enhanced. Results①All lesions were round or oval with clear boundaries. There were 6 cases in right lobe, 3 cases in left lobe, and the average diameter was 5.2cm. There are 5 cases with bleeding, 7 cases with enveloped. ②MRI findings： 7 cases showed slightly lower or equal signal on T1WI in phase, all signals could be seen reduced with strip or sheet on out-phase;all showed slightly higher or level mixed signal on fat suppression T2WI and slightly higher on DWI; All the 7 cases significantly enhanced at arterial phase, continued to strengthen at portal venous phase, 4 cases showed slightly signal and 1 case showed equal signal, 2 cases showed slightly lower signal at delayed phase. 2 cases showed slightly higher or equal signal on T1WI in phase, and reduced with sheet on out-phase; they showed slightly lower or equal signal on fat suppression T2WI and slightly lower on DWI; 1 case moderately enhanced and 1 case mild enhanced at arterial phase, both continued to strengthen at venous phase, with slightly lower signal at delay period. 7 cases with enveloped and delayed enhanced. Conclusion MRI examination could accurately display the organizational structure of HCA, and had certain characteristics, so that improved the differential diagnosis of liver lesions containing lipids and made a correct preoperative diagnosis.