Noreikaite Jurate, Albasha Dekan, Chidambaram Vijay, Arora Ankur, Katti Ashok
Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, United Kingdom.
World J Hepatol. 2021 Sep 27;13(9):1079-1097. doi: 10.4254/wjh.v13.i9.1079.
Different histopathological manifestations of focal liver lesions show varying common and uncommon imaging findings and some pathologies may show similar appearance despite of different histopathology. It is necessary to characterise focal liver lesions accurately as not only benign and malignant lesions are managed differently, but also certain benign lesions have differing management. These lesions are increasingly being detected due to rapid growth of use of cross-sectional imaging as well as improvement in image quality and new imaging techniques. Contrast enhanced magnetic resonance imaging (MRI) is considered the gold standard technique in characterising focal liver lesions. Addition of gadoxetic acid has been shown to significantly increase diagnostic accuracy in the detection and characterization of liver abnormalities. Classic imaging characteristics of common liver lesions, including their behaviour on gadoxetic acid enhanced MRI, have been described in literature over recent years. It is important to be familiar with the typical aspects of these lesions as well as know the uncommon and overlapping imaging features to reach an accurate diagnosis. In this article, we will review the well-described characteristic imaging findings of common and rare focal liver lesions and present several challenging cases encountered in the clinical setting, namely hepatocellular adenoma, focal nodular hyperplasia, hepatic angiomyolipoma, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, neuroendocrine tumours as well as a pleomorphic liposarcoma of the liver.
肝脏局灶性病变的不同组织病理学表现呈现出不同的常见和罕见影像学表现，尽管组织病理学不同，但某些病理表现可能相似。准确鉴别肝脏局灶性病变很有必要，因为不仅良性和恶性病变的处理方式不同，而且某些良性病变的处理方法也存在差异。由于横断面成像技术的快速发展、图像质量的提高以及新成像技术的出现，这些病变越来越多地被检测出来。对比增强磁共振成像（MRI）被认为是鉴别肝脏局灶性病变的金标准技术。已证明添加钆塞酸可显著提高肝脏异常检测和特征描述的诊断准确性。近年来，文献中描述了常见肝脏病变的经典影像学特征，包括它们在钆塞酸增强MRI上的表现。熟悉这些病变的典型特征以及了解罕见和重叠的影像学特征对于做出准确诊断很重要。在本文中，我们将回顾常见和罕见肝脏局灶性病变的详细特征性影像学表现，并展示临床中遇到的几个具有挑战性的病例，即肝细胞腺瘤、局灶性结节性增生、肝脏血管平滑肌脂肪瘤、肝细胞癌、肝内胆管癌、神经内分泌肿瘤以及肝脏多形性脂肪肉瘤。
