肝脏间叶性错构瘤CT及MRI表现

CT and MRI Performances of Mesenchymal Hamartoma of the Liver

目的探讨肝脏间叶性错构瘤（MHL）的CT、MRI特征。方法搜集6例经病理证实的MHL患者的CT、MRI资料,对病变的位置、大小、形态、平扫密度/信号、强化程度及方式进行分析,总结其影像学特征。结果6例MHL中,4例位于肝右叶,2例位于肝左叶。CT平扫2例呈低密度影,3例呈等-低密度影,1例呈等密度影;增强扫描2例病灶增强早期边缘见结节状强化影,后期强化逐渐向中心充填,但延迟期仍有点片状无强化区,3例病灶内见点条状不均匀强化,1例以间隔强化为主。MRI平扫T1WI上2例呈稍低信号,4例呈等、稍低混杂信号,在T2WI上4例呈稍高、高信号,2例呈等、稍高、高混杂信号;增强扫描2例病灶增强早期边缘见结节状强化,后期强化逐渐向中心充填,但延迟期仍有点片状无强化区,3例病灶增强早期见多发条索状不均匀强化影,后期强化较前明显,1例病灶内实性部分明显强化,囊性部分始终未见强化。结论 MHL CT、MRI表现具有一定的特异性,但由于该肿瘤相对少见,术前明确诊断仍存在一点的困难,易误诊,需要术后随访总结以提高诊断准确率。

Objective To discuss CT/MRI performances of mesenchymal hamartoma of the liver. Methods Preoperative CT/MRI data of 6 pathologically proven mesenchymal hamartoma of the liver were analyzed retrospectively. CT/MRI characteristics such as location,size,shape,density/signal,enhancement for each lesion were summarized. Results Among 6 lesions,4 cases were located in the right hepatic lobe,2 cases were in the left hepatic lobe. 2 cases were low density,3 cases were isodense or low density on CT scan. 2 cases had peripheral enhancement on the early phase,and enhancement from tumor edge to center on the later phase,but on the delayed phase there still had no enhancement area. 3 cases had inhomogeneous enhancement. 2 cases were slight hypointense,4 cases were isointense or slightly hypointense on T1 WI.4 cases were slightly hyperintense or obvious hyperintense,2 cases were slightly hyperintense,mildly hyperintense or isointense. 2 cases had peripheral enhancement on the early phase,and enhancement from tumor edge to center on the later phase,but on the delayed phase there still had no enhancement area. 3 cases had striped inhomogeneous enhancement on the early phase,and in the later phase the enhancement became more intensive. In 1 case,the solid component was marked enhanced,whereas the cystic part had no enhancement from beginning to end. Conclusion Performances of CT/MRI for had some specificities of mesenchymal hamartoma of the liver,but the tumor was rare. Preoperative diagnosis still had difficulties and could easily be misdiagnosed. We can only depend on pathological examination for absolute diagnoses and conclude the MRI/CT characteristics.