Podgorska Joanna, Anysz-Grodzicka Agnieszka, Cieszanowski Andrzej
Department of Radiology I, Maria Skłodowska-Curie Memorial Cancer Centre, Institute of Oncology, Ul. Roentgena 5, 02-781 Warszawa, Poland.
Curr Med Imaging Rev. 2019;15(5):435-442. doi: 10.2174/1573405614666171218154838.
Fat can be identified in numerous liver lesions, and usually is not a specific finding. Distinguishing between different kinds of fatty deposits is an important part of differential diagnosis. Magnetic Resonance Imaging (MRI) is superior to other imaging techniques because it allows distinguishing intracellular from macroscopic fat.
Intracellular lipid may be found in focal hepatic steatosis, hepatic adenoma, hepatocellular carcinoma and, less commonly, in focal nodular hyperplasia as well as regenerative and dysplastic nodules. Macroscopic fat is seen in angiomyolipoma, lipoma, metastases from fatcontaining neoplasms, primary or metastatic liposarcoma, hydatid cyst, pseudolipoma of the Glisson capsule, pericaval fat collection, lipopeliosis, hepatic teratoma, focal hepatic extramedullary haematopoiesis and adrenal rest tumour.
Liver nodules should be characterised with regard to underlying liver condition, MRI characteristics and contrast enhancement pattern, including hepatobiliary phase. In many cases, identification of fatty content may help narrowing the differential diagnosis.
在众多肝脏病变中均可发现脂肪,且通常并非特异性表现。区分不同类型的脂肪沉积是鉴别诊断的重要部分。磁共振成像(MRI)优于其他成像技术,因为它能够区分细胞内脂肪与肉眼可见的脂肪。
细胞内脂质可见于局灶性肝脂肪变性、肝腺瘤、肝细胞癌,较少见于局灶性结节性增生以及再生结节和发育异常结节。肉眼可见的脂肪见于血管平滑肌脂肪瘤、脂肪瘤、含脂肪肿瘤的转移瘤、原发性或转移性脂肪肉瘤、包虫囊肿、Glisson 包膜假脂肪瘤、腔静脉周围脂肪聚集、脂肪性紫癜、肝畸胎瘤、局灶性肝髓外造血以及肾上腺残余肿瘤。
肝脏结节应根据潜在肝脏状况、MRI 特征及对比增强模式(包括肝胆期)进行特征描述。在许多情况下,识别脂肪成分可能有助于缩小鉴别诊断范围。