Sun Jun, Wang Shouan, Chen Wenxin, Wu Jingtao
Department of Radiology, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.
Oncol Lett. 2015 Aug;10(2):1145-1148. doi: 10.3892/ol.2015.3368. Epub 2015 Jun 11.
The present study reports a case of histologically proven hepatic epithelioid angiomyolipoma that was evaluated with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging and diffusion-weighted imaging. A 23-year-old female was admitted to the Northern Jiangsu People's Hospital (Yangzhou, Jiangsu, China) due to a 5.6-cm mass in the liver, and a right partial hepatectomy was performed. Magnetic resonance imaging (MRI) revealed a hypointense mass on T1-weighted imaging, and a hyperintense mass on T2-weighted and diffusion-weighted imaging, with a higher apparent diffusion coefficient value compared with normal liver parenchyma. On the dynamic Gd-EOB-DTPA-enhanced MRI scan, the lesion manifested as hypervascular with multiple filiform vessels and a pseudocapsule image, and in the hepatobiliary phase the lesion demonstrated a lack of contrast retention, thus appearing hypointense compared with the background liver. Pre-operatively, EMAL was diagnosed on the basis of these findings in the tumor. The optimum treatment is complete surgical excision and subsequent follow-up. The patient was healthy and free from recurrence at 6 months and 1 year post-surgery. Therefore, knowledge of EAML specific features on dynamic Gd-EOB-DTPA-enhanced and DWI scans may improve the diagnostic accuracy of hypervascular hepatic tumors and may facilitate treatment selection.
本研究报告了一例经组织学证实的肝上皮样血管平滑肌脂肪瘤病例,该病例接受了钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像和扩散加权成像评估。一名23岁女性因肝脏出现5.6厘米肿块入住苏北人民医院(中国江苏扬州),并接受了右半肝切除术。磁共振成像(MRI)显示,该肿块在T1加权成像上呈低信号,在T2加权成像和扩散加权成像上呈高信号,表观扩散系数值高于正常肝实质。在动态Gd-EOB-DTPA增强MRI扫描中,病变表现为多血管,有多个丝状血管和假包膜影像,在肝胆期病变表现为无对比剂滞留,因此与背景肝脏相比呈低信号。术前,根据肿瘤的这些表现诊断为EMAL。最佳治疗方法是完整手术切除并随后进行随访。该患者在术后6个月和1年时健康且无复发。因此,了解动态Gd-EOB-DTPA增强扫描和DWI扫描上EAML的特定特征可能会提高富血管性肝肿瘤的诊断准确性,并有助于治疗选择。