肝上皮样血管平滑肌脂肪瘤的影像学表现

Imaging features of hepatic epithelioid angiomyolipoma

目的:探讨肝上皮样血管平滑肌脂肪瘤(epithelioid angiomyolipoma,EAML)的影像学表现,提高对其的认识。方法:回顾性分析3例经手术病理证实的肝EAML患者的临床及影像学资料,3例均行CT检查,其中1例稍后行MRI检查。结果:3例均为单发病灶,其中2例EAML影像学表现同血管平滑肌脂肪瘤,即肿瘤大部分为脂肪成分,并见分隔,增强扫描分隔有强化。1例为乏脂型EAML,其影像学特征包括:(1)病灶呈类圆形,边缘光整,CT平扫呈稍低密度,磁共振呈长T1、长T2信号。(2)增强扫描动脉期呈明显强化,中央可见粗大畸形血管。(3)静脉期及延迟期强化程度下降。结论:多脂型EAML易于诊断,乏脂型EAML缺乏特异性的影像学表现,需密切结合临床诊断。

Objective To investigate the image features of hepatic epithelioid angiomyolipoma（EAML） to improve its diagnosis. Methods Totally 3 hepatic EAML patients confirmed surgically underwent CT examination, of whom there was one case went through MRI examination a while after, and then had their clinical and imaging data analyzed retrospectively.Results Solitary lesions were found in all the 3 cases. There were 2 ones with the imaging features of angiomyolipoma,including dominance of fat component as well as septa which showed strengthening with enhancement scanning, the remained one suffered from asteatotic EAML with the imaging features including round-like and well-defined lesion, low density on plain CT, hypo-signal intensity on T1 WI and hyper-signal intensity on T2 WI, obvious enhancement as well as enlarged and anomalous vessels at arterial phase during enhancement scanning, and weakened enhancement at venous phase and delay phase. Conclusion Lipid-rich EAML is easy to diagnose, while asteatotic EAML has to be diagnosed by combined imaging features and clinical data.