肝脏血管平滑肌脂肪瘤的CT与对比增强超声表现及病理相关性比较

Comparison of CT and contrast-enhanced ultrasound findings in hepatic angiomyolipoma with pathological correlations.

作者信息

Li Rui, Tang Chun-Lin, Cai Ping, Ma Kuan-sheng, Zhang Xiao-Hang, Ding Shi-Yi, Zhang Yi, Guo De-Yu, Yan Xiao-Chu

机构信息

Department of Ultrasound, Southwest Hospital Affiliated to Third Military Medical University, Chongqing, People's Republic of China.

Department of Hepato-biliary-Pancreatic Surgery, Southwest Hospital Affiliated to Third Military Medical University, No.30, Gaotangyan Street, Shapingba, Chongqing, 400038, People's Republic of China.

出版信息

Abdom Radiol (NY). 2016 Feb;41(2):248-56. doi: 10.1007/s00261-015-0571-0.

DOI:10.1007/s00261-015-0571-0

PMID:26867906

Abstract

OBJECTIVE

To compare imaging findings of CT and contrast-enhanced US (CEUS) in hepatic angiomyolipoma (HAML) and investigate their pathological correlations.

METHODS

Imaging findings and preoperative diagnosis of CT and CEUS were retrospectively compared head to head in 46 patients with 54 histologically proven HAMLs. Correlations between imaging features and preoperative diagnosis with pathological types of HAMLs were analyzed.

RESULTS

Fat was detected in 100% of lipomatous type, 84.6% of mixed type, and 7.1% of myomatous type (p = 0.000) of HAML at unenhanced CT. Well-defined hyper-echogenicity was displayed in 100% of lipomatous type, 88.5% of mixed type, 50% of myomatous type, and 66.7% of angiomatous type of HAMLs at unenhanced US. More arterial hyper-enhancement was noted on CEUS (100%) than on CT (73.1%) in mixed type (p = 0.015) and in lipomatous type (90.9% vs. 9.1%, p = 0.000) of HAMLs. Washout was present in more HAMLs on CT than on CEUS (42.6% vs. 18.5%, p = 0.007). Correct preoperative diagnosis was suggested in more HAMLs of myomatous type on CEUS than on CT (42.9% vs. 0%, p = 0.016) but showed no difference in other types of HAMLs.

CONCLUSION

There are considerable discrepancies between CT and CEUS findings of HAMLs, and the imaging appearance and preoperative diagnosis of HAMLs on CT and CEUS are significantly affected by pathological types of HAMLs.

摘要

目的

比较肝脏血管平滑肌脂肪瘤（HAML）的CT和超声造影（CEUS）影像学表现，并探讨它们与病理的相关性。

方法

回顾性对比分析46例经组织学证实的54个HAML患者的CT和CEUS影像学表现及术前诊断情况。分析影像学特征及术前诊断与HAML病理类型之间的相关性。

结果

平扫CT显示脂肪瘤型HAML脂肪检出率为100%，混合型为84.6%，肌瘤型为7.1%（p = 0.000）。未增强超声显示脂肪瘤型HAML的边界清晰的高回声率为100%，混合型为88.5%，肌瘤型为50%，血管瘤型为66.7%。CEUS显示混合型（p = 0.015）和脂肪瘤型（90.9%对9.1%，p = 0.000）HAML的动脉期强化比CT更多（分别为100%和73.1%）。CT显示HAML的廓清比CEUS更多（42.6%对18.5%，p = 0.007）。CEUS对肌瘤型HAML术前正确诊断率高于CT（42.9%对0%，p = 0.016），但在其他类型HAML中无差异。