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目的 讨论肝血管平滑肌脂肪瘤(HAML)的CT和MR表现,以进一步提高诊断准确性.方法 搜集经临床及病理证实的HAML 16例,分型讨论影像学表现,总结其分型诊断价值及其病理基础.结果 血管瘤型2例,病灶以粗大、扭曲的血管成分为主,增强后呈动脉瘤样强化.肌瘤型3例,病变以平滑肌成分为主,增强后呈渐进性强化.脂肪瘤型5例,影像学检查可见明显脂肪组织.混合型6例,病灶成分混杂,CT或MRI检查可见脂肪组织及小血管影,增强后病变持续强化.免疫组织化学检测,本组病例HMB-45、A103均为(+).结论 CT、MRI能较好地反映HAML的组成成分及其病理特征,具有一定的诊断特异性.“,”Objective To investigate the CT and MRI findings of hepatic angiomyolipoma (HAML) in order to improve its diagnosis accuracy.Methods A total of 16 cases with pathologically-confirmed hepatic angiomyolipomas were collected.The imaging features were retrospectively analyzed,and the grading of HAML and its pathological basis were discussed.Results Hepatic angiomyolipomas could be classified into four types.(1) Angiomatous type was seen in 2 cases.Abnormal thickened and tortuous vessels could be commonly seen in the lesions,which showed aneurysmal enhancement lasting from early arterial phase till portal venous phase.(2) Myomatous type was found in 3 cases.The lesions were mainly composed of smooth muscles mixed with small amount of adipose tissue,which showed gradual enhancement after injection of contrast.(3) Lipomatous type was confirmed in 5 cases.The lesions were mainly composed of mature adipose tissue,which could be easily demonstrated on both CT and MRI.(4) Mixed type was observed in 6 cases.The composition of the lesion was complex.Adipose tissue and small blood vessels could be detected on CT or MRI scans,which showed continuing enhancement.Immunohistochemical examination showed that the markers of both HMB-45 and A103 were positive in all cases.Conclusion Both CT and MRI can well reflect the composition and pathological features of hepatic angiomyolipomas.Therefore,CT and MRI examination carry higher specificity for the diagnosis of hepatic angiomyolipomas.