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目的探讨肝脏血管平滑肌脂肪瘤(hepatic angiomyolipoma,HAML)CT和MRI的诊断价值。资料与方法回顾性分析经病理证实的8例肝脏HAML的CT和MRI表现。8例均行CT平扫和多时相动态增强扫描,其中4例同时行MRI平扫和多时相动态增强扫描。结果 8例均为单发混合型HAML,CT平扫均表现为低于周围正常肝组织的混杂低密度,灶内含有不同程度的脂肪密度,CT值-40～40HU。4例MRI平扫表现为稍长T1(含短T1)、稍长T2混杂信号,T1WI上高信号在使用脂肪抑制技术后完全消失。CT与MRI多时相动态增强扫描显示动脉期病灶均呈显著不均匀强化,门静脉期6例CT、3例MRI病灶呈持续或渐进性中重度强化,高于周围正常肝实质,2例CT、1例MRI病灶轻中度强化;3例HAML见假包膜,且在门静脉期及延迟期有轻度强化。结论 CT和MRI能显示混合型HAML的特征性表现并可在术前做出准确诊断。
Objective To investigate the diagnostic value of CT and MRI in hepatic angiomyolipoma (HAML). Materials and Methods Retrospective analysis of CT and MRI findings of pathologically confirmed HAML in 8 cases. 8 cases underwent CT scan and multi-phase dynamic contrast-enhanced scan, of which 4 cases underwent both MRI plain scan and multi-phase dynamic contrast-enhanced scan. Results All the 8 cases were single mixed type HAML. CT scan showed less mixed low density than the surrounding normal liver tissue. The lesions contained different degrees of fat density and the CT value was -40 ~ 40HU. Four cases of MRI showed a slightly longer T1 (including short T1), slightly longer T2 mixed signal, and the high signal on T1WI completely disappeared after using fat suppression technique. CT and MRI multi-phase dynamic contrast-enhanced MRI showed significant heterogeneity in arterial phase, 6 cases of portal venous phase CT, 3 cases of MRI lesions showed progressive or progressive moderate to severe enhancement, higher than the surrounding normal liver parenchyma, 2 cases of CT, 1 Cases of MRI lesions mild to moderate enhancement; 3 cases of HAML see pseudocapsules, and in the portal vein and delayed mild enhancement. Conclusion CT and MRI can show the characteristic features of mixed HAML and make accurate diagnosis before operation.