肝内胆管腺瘤的CT、MRI表现特征(附2例报告并文献复习)

CT and MRI Features of Intrahepatic Bile Duct Adenoma( Two Cases and Review of Literature)

目的探讨肝内胆管腺瘤(BDA)的CT、MRI表现特征,以提高对该病的认识。方法回顾性分析2例经手术病理证实的肝内BDA的临床、影像及病理学资料,结合文献重点讨论其CT、MRI表现特点。结果 1例表现为肝右前叶下段被膜下结节,CT平扫呈稍低密度,MRI平扫T_1WI呈低信号,T_2WI呈高信号,增强扫描呈快进快出强化方式,周边见晕环征,延迟期见小斑片状延迟强化。肝胆特异期病灶呈低信号。1例为肝右后叶上段被膜下的病灶,T_1WI呈稍低信号,T_2WI呈稍高信号,强化方式与前相同,周边也见晕环征。结论肝内BDA的影像表现有一定特征,多表现为靠近肝脏表面,体积较小,富血供,延迟强化;少数表现为快进快出的强化方式,有时周围见晕环影。

Objective To investigate the CT and MRI features of intrahepatic bile duct adenoma（ BDA）. Methods The imaging materials,clinical data and pathological data of two patients with BDA were retrospectively analyzed. Results Case 1-The liver CT showed slight low density focus in the inferior segment of the right anterior lobe. The lesion showed an abnormal signal in MRI,which were hypointensity in T1 WI,hyperintensity in T2 WI. The enhanced scan of CT and MRI showed obvious heterogeneous enhancement in the arterial phase and hypointensity in the portal phase,with halos in ring.The central portion of lesion showed delayed patchy enhancement and the lesion showed hypointensity in the hepatobiliary phase. Case 2-The liver MRI showed a round-like focus,with an abnormal signal in the superior segment of the right posterior lobe,with slight hypointensity in T1 WI,slight hyperintensity in T2 WI. The enhancement style was similiar with case1,with halos in ring. Conclusion BDA has characteristic imaging findings,including subcapsular location,small size,hypervascularity,continuous enhancement; the minority manifested enhancement of fast-in and fast-out,with halos in ring.