肝细胞腺瘤的MRI诊断价值

摘要/Abstract

摘要： 目的研究肝细胞腺瘤的MRI诊断价值。方法选取自2011年2月至2014年2月于本院就诊并经病理证实的肝细胞腺瘤患者20例,回顾性分析其MRI表现及术前诊断,比较其与病理结果差异。结果本研究20例患者,18例为单发病灶,1例为2个病灶,1例为多发病灶(6个病灶),病灶总计26个;T1WI上稍低信号影病灶23个,稍高信号影病灶3个;T2WI上高信号影病灶16个,低信号影病灶10个。DWI上稍高信号影病灶17个,等信号影病灶9个,富含脂质信号影病灶24个。增强扫描结果中动脉期所有病灶均明显强化;门脉期稍低信号影病灶16个,稍高信号影病灶10个;延迟扫描结果显示稍低信号影病灶19个,等信号影病灶7个。出现假包膜环状强化病灶10个。26个病灶与周围正常组织ADC比值均＞1。结论 MRI提示病灶富含脂质、血供及有包膜同时排除肝细胞癌等病变,并测量病灶ADC值显示与正常肝组织ADC比值>1时,可为肝细胞腺瘤诊断提供可靠依据。

张绪翠, 华冰, 曲宝俊. 肝细胞腺瘤的MRI诊断价值[J]. 肝脏, 2016, 21(11): 956-959.

参考文献

[1] 汪华霖,蒋怡帆,龚建平,等.肝细胞腺瘤.中国现代普通外科进展,2012,15: 711-713.
[2] Frulio N, Chiche L, Bioulac-Sage P, et al. Hepatocellular adenomatosis: what should the term stand for.Clin Res Hepatol Gas, 2014, 38: 132-136.
[3] Karkar AM, Tang LH, Kashikar ND, et al. Management of hepatocellular adenoma: comparison of resection, embolization and observation. HPB, 2013, 15: 235-243.
[4] Agrawal S, Agarwal S, Arnason T, et al. Management of hepatocellular adenoma: Recent advances. Clin Gastroenterol, 2014, 13: 1221-1230.
[5] 刘立国,吴凡,吴健雄,等.肝细胞腺瘤和肝腺瘤病11例诊治分析.中华肝胆外科杂志, 2012,18: 166-168.
[6] 安松林,王黎明,荣维淇,等.肝细胞腺瘤的临床诊治及文献复习.肝胆胰外科杂志,2013, 25: 448-451,455.
[7] Dimitroulis D, Charalampoudis P, Lainas P, et al. Focal nodular hyperplasia and hepatocellular adenoma: current views. Axta Chir Belg, 2013, 113: 162-169.
[8] 郭文伟,马洪宇,顾志强,等.肝细胞腺瘤的MRI诊断价值.中国CT和MRI杂志,2015, 13: 87-89.
[9] Pérez Rojas J, Guarín Corredor MJ, Artes Martinez MJ, et al. Immunophenotypic classification of 3 cases of hepatocellular adenoma. Differential diagnosis with focal nodular hyperplasia. Gastroenterol Hepatol, 2013, 36: 388-395.
[10] Goltz D, Fischer HP. Current proceedings in the molecular dissection of hepatocellular adenomas: Review and hands-on guide for diagnosis. Int J Mol Sci, 2015, 16: 20994-21007.
[11] 韦立新,杜经丽,王玉兰,等.高分化肝细胞癌的病理形态学特征及其病理学诊断与鉴别诊断.中华病理学杂志,2014,43: 459-462.
[12] 杨秋霞,张嵘,吴静,等.肝细胞腺瘤的影像学表现与组织病理学的相关性.中国CT和MRI杂志,2013,11: 48-52,71.
[13] Laumonier H, Cailliez H, Balabaud C, et al. Role of contrast-enhanced sonography in differentiation of subtypes of hepatocellular adenoma: correlation with MRI findings.AM J Roentgenol, 2012, 199: 341-348.
[14] 张艳芹,孙培祥,张啸波,等.肝细胞腺瘤的MRI诊断价值.中国CT和MRI杂志,2015, 13: 55-57.
[15] Srirattanapong S, Angthong W, Kim BS, et al. Liver adenomatosis: serial investigation on MRI. Abdom Imaging, 2014, 39: 269-282.
[16] 邓雪松,倪勇,王成友,等.肝细胞腺瘤诊断与外科治疗的体会.肝胆外科杂志, 2014, 22: 196-199.
[17] Denecke T, Steffen IG, Agarwal S, et al. Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI. Eur Radiol, 2012, 22: 1769-1775.
[18] 赵晶,赵心明,欧阳汉,等.肝细胞腺瘤的影像表现及与病理结果的对照分析.中华放射学杂志,2012,46: 1096-1100.
[19] Grazioli L, Olivetti L, Mazza G, et al. MR Imaging of Hepatocellular Adenomas and Differential Diagnosis Dilemma. Hepatol Int, 2013, 2013: 374170-374170.
[20] 潘金锋,陈伶俐,樊嘉,等.肝细胞腺瘤36例临床分析.中华消化杂志, 2012, 32: 341-342.