Gallix B, Aufort S
Service d'Imagerie Médicale, Hôpital Saint Eloi, CHU de Montpellier, 80, avenue Augustin Fliche, 34295 Montpellier Cedex 5.
J Radiol. 2007 Jul-Aug;88(7-8 Pt 2):1048-60. doi: 10.1016/s0221-0363(07)89918-5.
A liver incidentaloma corresponds to a liver lesion detected during work-up of for unrelated pathology. The frequency of incidentalomas is directly related to the incidence of liver tumors in the general population. After detection of an incidental liver lesion, the goal is to assess if diagnosis can be made based on imaging features alone or if biopsy is required. As such, radiologists must be familiar with the imaging features of different types of liver lesions, irrespective of the imaging modality. US is useful to determine the number of lesions (single versus multiple) and the cystic or solid nature of each lesion. Cystic lesions are usually benign. Incidental solid liver lesions are typically benign, but detection of a malignant lesion, hepatocellular carcinoma and metastases, is possible. The most frequent benign incidental solid liver lesions are hemangioma, focal nodular hyperplasia and liver cell adenoma. Accurate imaging diagnosis may not always be achievable, and biopsy, percutaneous or surgical, may be required.
肝脏偶发瘤是指在因无关病理情况进行检查时发现的肝脏病变。偶发瘤的发生率与普通人群中肝脏肿瘤的发生率直接相关。在发现肝脏偶发病变后，目标是评估能否仅根据影像学特征做出诊断，或者是否需要进行活检。因此，放射科医生必须熟悉不同类型肝脏病变的影像学特征，无论采用何种成像方式。超声有助于确定病变的数量（单发与多发）以及每个病变的囊性或实性性质。囊性病变通常为良性。肝脏偶发实性病变通常为良性，但也有可能检测到恶性病变，如肝细胞癌和转移瘤。最常见的良性肝脏偶发实性病变是血管瘤、局灶性结节性增生和肝细胞腺瘤。准确的影像学诊断并非总能实现，可能需要进行经皮或手术活检。
