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目的探讨2例经病理证实的肝脏上皮样血管平滑肌脂肪瘤(epithelioid angiomyolipoma,EAML)的CT表现。方法回顾分析2例经手术病理证实的肝脏EAML CT资料并结合文献讨论。结果 2例均为女性,年龄分别为38岁和49岁,1例上腹部疼痛,另1例因右侧下腹部包块就诊时偶然发现。实验室检查均未见异常。CT表现:肿瘤分别位于肝Ⅱ/Ⅶ段;平扫均呈稍低密度,其中例1内见少量脂肪成分;动态增强扫描分别呈“快进慢出”、“快进快出”强化方式,动脉期均可见增粗、迂曲的供血血管影;病例1动态增强示大片边界清楚的囊性密度区。结论肝脏EAML CT像上具有一定的特征性,表现为富血供、含少量或不含脂肪成分,内部可见边界清楚的囊性密度区。病灶缺乏脂肪成分、强化方式呈“快进快出”时易误诊为肝细胞癌。
Objective To investigate the CT findings of 2 pathologically confirmed epithelioid angiomyolipoma (EAML). Methods Retrospective analysis of 2 cases of pathologically confirmed liver EAML CT data and literature review. Results Both cases were female and were 38 years old and 49 years old respectively. One case had upper abdominal pain and the other case was found accidentally by the right lower abdominal mass. No abnormal laboratory tests. CT findings: The tumors were located in the liver Ⅱ / Ⅶ segment; plain showed a slightly lower density, including a small amount of fat in Example 1 see the composition; dynamic enhanced scan was “fast forward slow”, “ ”Fortified mode, thickening of the arterial phase are visible, tortuous blood vessels; Case 1 dynamic enhanced large cysts show a clear cystic density area. Conclusions The liver EAML CT images have some characteristic features, such as rich blood supply, small or no fat content, and clear cystic densities in the interior. Focal lack of fat composition, strengthen the way was “fast forward faster ” easily misdiagnosed as hepatocellular carcinoma.