螺旋CT及超声对肝腺瘤的诊断价值

Application of spiral CT and ultrasound in diagnosis of hepatic adenoma

目的分析肝腺瘤螺旋CT及超声表现,评估其诊断价值。方法回顾性分析2009年7月-2015年12月在廊坊市中医医院经病理证实的15例肝腺瘤患者的螺旋CT及超声表现。结果 15例患者超声呈低回声、等回声或高回声。其中7例为单发肝腺瘤,低密度4例、略低密度1例、等密度2例;动脉期呈明显强化5例、中度强化1例、轻度强化1例;门静脉期及延时期呈强化降低3例、等密度2例、渐进性强化2例。8例为多发肝腺瘤,80个病灶,4个病灶(3例)呈混杂密度、40个病灶(4例)呈低密度、36个病灶(4例)呈略低密度;8个病灶(4例)动脉期明显强化,门静脉期及延时期强化降低;3个病灶(1例)动脉期明显强化,门静脉期及延时期呈等密度;18个病灶(2例)动脉期及门静脉期明显强化,延时期强化降低;49个病灶(5例)动脉期中度强化,门静脉期及延时期强化降低;2个病灶(1例)各期未见明显强化。螺旋CT对单发肝腺瘤和多发肝腺瘤的诊断正确率分别为14.3%(1/7)、87.5%(7/8)。结论超声仅能提示占位,但不能定性;螺旋CT三期增强扫描对肝腺瘤的诊断,尤其是对多发肝腺瘤的诊断有较高价值。

Objective To investigate the spiral CT and ultrasound findings of hepatic adenoma and the value of spiral CT and ultrasound in the diagnosis of hepatic adenoma. Methods A retrospective analysis was performed for the spiral CT and ultrasound findings of 15 patients with pathologically confirmed hepatic adenoma in Langfang Hospital of Traditional Chinese Medicine from July 2009 to December 2015. Results All the 15 patients showed hypoechoic,isoechoic,or hyperechoic ultrasound findings. Seven of these patients had single hepatic adenoma. In the 7 cases,4 had low-density lesions,1 had a slightly low-density lesion,and 2 had equal-density lesions; as for the arterial phase,5 showed obvious enhancement,1 showed moderate enhancement,and 1 showed mild enhancement; as for the portal venous phase and delayed phase,3 showed reduced enhancement,2 had equal-density lesions,and 2 showed gradual enhancement. Eight patients experienced multiple hepatic adenoma with 80 lesions in total. In the 80 lesions,4 lesions（ 3 patients） showed a mixed density,40 lesions（ 4patients） showed a low density,36 lesions（ 4 patients） showed a slightly low density; 8 lesions（ 4 patients） showed obvious enhancement in the arterial phase and reduced enhancement in the portal venous phase and delayed phase; 3 lesions（ 1 patient） showed obvious enhancement in the arterial phase and an equal density in the portal venous phase and delayed phase; 18 lesions（ 2 patients） showed obvious enhancement in the arterial phase and portal venous phase and reduced enhancement in the delayed phase; 49 lesions（ 5 patients） showed moderate enhancement in the arterial phase and reduced enhancement in the portal venous phase and delayed phase; 2 lesions（ 1 patient）showed no enhancement in any phase. The correct rates of spiral CT in the diagnosis of single hepatic adenoma and multiple hepatic adenomas were 14. 3%（ 1 /7） and 87. 5%（ 7 /8）,respectively. Conclusion Ultrasound can only suggest space-occupying lesions,but cannot analyze the lesions qualitatively; spiral CT with three-phase enhancement scanning has a great value in the diagnosis of hepatic adenoma,especially multiple hepatic adenoma.