| 俞顺,蔡佳玲,王才虹,林敏贵,马明平,包强.三维容积多期增强MR诊断乏脂型肝血管平滑肌脂肪瘤[J].中国医学影像技术,2020,36(2):252~255 |
| 三维容积多期增强MR诊断乏脂型肝血管平滑肌脂肪瘤 |
| 3D volume multi-phase enhanced MR for diagnosis of hepatic epithelioid angiomyolipoma with minimal fat |
| 投稿时间：2019-06-05 修订日期：2020-01-30 |
| DOI：10.13929/j.issn.1003-3289.2020.02.018 |
| 中文关键词: 血管平滑肌脂肪瘤 肝 磁共振成像 |
| 英文关键词:angiomyolipoma liver magnetic resonance imaging |
| 基金项目:福建省自然科学基金项目（2017J01172）、中华国际医学交流基金会SKY影像科研基金发展项目（Z-2014-07-1912）。 |
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| 中文摘要: |
| 目的 探讨三维容积多期增强MR对诊断乏脂型肝血管平滑肌脂肪瘤（HEAML）的价值。方法 回顾性分析22例经病理证实的HEAML，重点观察三维容积多期增强MRI所示病灶供血动脉、引流静脉及中心血管。结果 22处HEAML病灶中，17处MRI同时显示病灶供血动脉和引流静脉，2处仅见供血动脉，1处仅见引流静脉，2例未见供血动脉或引流静脉。9处病灶血供来自肝动脉分支，7处来自门静脉属支，3处同时存在肝动脉及门静脉血供。引流静脉多于动脉期提早显影，汇入下腔静脉及肝静脉各9处；10处动脉期见病灶内部及周边扭曲血管，8处见假包膜征；15处病灶不含脂肪，7处含少量脂肪，6处病灶合并出血、坏死。4例接受肝细胞特异性对比剂增强检查，病灶在肝胆期均呈低信号。结论 三维容积多期增强MR可显示HEAML病灶供血动脉、引流静脉及中心血管，对乏脂型肝EAML有较高诊断价值。 |
| 英文摘要: |
| Objective To explore the value of 3D volume multi-phase enhanced MR for diagnosis of hepatic epithelioid angiomyolipoma (HEAML) with minimal fat. Methods Clinical data and MRI features of HEAML in 22 patients confirmed by pathology and immunohistochemistry were analyzed retrospectively. The feeding arteries, early draining veins and central vessels revealed by 3D volume multi-phase enhanced MRI were particularly observed. Results Among 22 HEAML lesions, feeding arteries and draining veins were observed at the same time in 17 lesions, only feeding arteries were noticed in 2 lesions, only draining vein was found in 1 lesion, while no feeding artery nor draining vein was detected in 2 lesions. The feeding vessels of 9 lesions originated from branches of hepatic arteries, of 7 lesions from branches of portal vein, while of 3 lesions from both branches of hepatic arteries and portal vein. The draining veins mainly developed in advance during arterial phase, transferred into inferior vena cava or hepatic veins (each n=9). In the arterial phase, distorted vessels inside and around lesions were observed, while pseudocapsule sign was seen in 8 lesions. Totally 15 lesions were free of fat, 7 contained a small amount of fat and 6 with hemorrhage and necrosis. Liver-specific contrast agent enhanced MR scanning was performed in 4 patients, and all 4 HEAML lesions showed hypointensity in hepatobiliary phase. Conclusion 3D volume multi-phase enhanced MR examination is beneficial to reveal the feeding arteries, draining veins and central venules of HEAML lesions, which is of high diagnostic value for diagnosis of HEAML with minimal fat. |
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