Department of Ultrasound, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of General Surgery, Guangzhou Digestive Disease Center, Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong, China.
Ultrasound Med Biol. 2021 Mar;47(3):446-453. doi: 10.1016/j.ultrasmedbio.2020.11.021. Epub 2021 Jan 7.
Hepatic angiomyolipoma (HAML) comprises epithelioid angiomyolipoma (EAML) and classic hepatic angiomyolipoma (CAML). The imaging appearance of HAML varies widely, and EAML is more easily misdiagnosed as hepatocellular carcinoma (HCC) than as CAML. The clinical and contrast-enhanced ultrasound (CEUS) features of CAML, EAML and HCC with negative alpha-fetoprotein protein expression (HCC[AFP-]) were retrospectively reviewed. The hyper-vascular type was more commonly found in CAML and EAML lesions than in HCC lesions. Most lesions were hyper-enhanced in the arterial phase. CAMLs showed prolonged hyper-enhancement or iso-enhancement during the portal and late phases on CEUS, making them easily distinguishable from HCC(AFP-). Some EAML lesions (41.7%) were hypo-echoic, similar to HCC(AFP-). However, the hypo-enhancement of EAML lesions occurred later than that of HCC(AFP-) lesions. Thus, our findings may be useful in distinguishing among these lesions to improve diagnostic accuracy.
肝血管平滑肌脂肪瘤（HAML）包括上皮样血管平滑肌脂肪瘤（EAML）和经典肝血管平滑肌脂肪瘤（CAML）。HAML 的影像学表现差异很大，EAML 比 CAML 更容易误诊为肝细胞癌（HCC）。回顾性分析了 CAML、EAML 和 AFP 阴性 HCC（HCC[AFP-]）的临床及超声造影（CEUS）特征。在 CAML 和 EAML 病变中，富血管型比 HCC 病变更常见。大多数病变在动脉期呈高增强。CAML 在 CEUS 门静脉期和延迟期呈持续高增强或等增强，与 HCC（AFP-）容易区分。一些 EAML 病变（41.7%）呈低回声，与 HCC（AFP-）相似。然而，EAML 病变的低增强出现时间晚于 HCC（AFP-）病变。因此，我们的发现可能有助于鉴别这些病变，提高诊断准确性。
