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钆塞酸二钠增强及扩散加权磁共振成像对肝脏上皮样血管平滑肌脂肪瘤的诊断价值:一例报告

Gd-EOB-DTPA-enhanced and diffusion-weighted magnetic resonance findings in hepatic epithelioid angiomyolipoma: A case report.

作者信息

Sun Jun, Wang Shouan, Chen Wenxin, Wu Jingtao

机构信息

Department of Radiology, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, Jiangsu 225001, P.R. China.

出版信息

Oncol Lett. 2015 Aug;10(2):1145-1148. doi: 10.3892/ol.2015.3368. Epub 2015 Jun 11.

DOI:10.3892/ol.2015.3368
PMID:26622641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4509382/
Abstract

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.

摘要

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。

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