Cai Pei-qiang, Wu Yao-pan, Xie Chuan-miao, Zhang Wei-dong, Han Rui, Wu Pei-hong
State Key Laboratory of Oncology in South China, 651 Dongfengdong Road, Guangzhou, Guangdong, People's Republic of China.
Abdom Imaging. 2013 Jun;38(3):482-9. doi: 10.1007/s00261-012-9932-0.
The objective of this study is to evaluate the clinical, pathologic, and computed tomography (CT) and/or magnetic resonance imaging (MRI) findings of hepatic angiomyolipoma (HAML) and to improve the diagnostic efficacy of the tumor.
Clinical, pathologic, and imaging findings were retrospectively evaluated in 18 patients with HAML. Two patients underwent both CT and MRI, ten underwent CT alone, and six underwent MRI alone. Unenhanced and contrast-enhanced examinations were performed in all patients. Imaging characteristics, such as the lesion location, lesion diameter, presence of early draining veins, attenuation/signal intensity of the lesions on imaging, and enhancement pattern were reviewed.
There were 3 male and 15 female patients. HAML was seen as a well-defined, solitary mass on imaging with medium size (mean diameter, 5.9 cm). Fat was detected in ten patients. Calcification was noted in two patients and cystic degeneration was seen in one patient. Hepatic cirrhosis and capsule were not detected in all patients. The mean attenuation values exceeded 120 hounsfield units (HU) in 11 patients (91.7%). Peripherally decreasing enhancement rim as well as early draining vein was seen in 15 patients (83.3%). The early draining veins were all hepatic veins. Tumor vessels were noted in all patients.
The presence of early draining vein, peripheral decreasing enhancement rim, and the absence of tumor capsule in the hypervascular hepatic tumor on CT and/or MRI together with normal alpha fetal protein may be helpful for the diagnosis of HAML in non-cirrhotic liver.
本研究旨在评估肝脏血管平滑肌脂肪瘤（HAML）的临床、病理及计算机断层扫描（CT）和/或磁共振成像（MRI）表现，以提高该肿瘤的诊断效能。
对18例HAML患者的临床、病理及影像学表现进行回顾性分析。2例患者同时接受了CT和MRI检查，10例仅接受了CT检查，6例仅接受了MRI检查。所有患者均进行了平扫和增强检查。回顾了病变位置、病变直径、早期引流静脉的存在情况、影像学上病变的衰减/信号强度以及增强模式等影像学特征。
男性患者3例，女性患者15例。HAML在影像学上表现为边界清晰的孤立性肿块，大小中等（平均直径5.9 cm）。10例患者检测到脂肪。2例患者有钙化，1例患者有囊性变。所有患者均未检测到肝硬化和包膜。11例患者（91.7%）的平均衰减值超过120亨氏单位（HU）。15例患者（83.3%）可见周边递减强化环及早期引流静脉。早期引流静脉均为肝静脉。所有患者均可见肿瘤血管。
CT和/或MRI上表现为高血供肝脏肿瘤出现早期引流静脉、周边递减强化环且无肿瘤包膜，同时甲胎蛋白正常，可能有助于非肝硬化肝脏中HAML的诊断。
