CAJ | 학술논문

目的：探讨肝脏血管平滑肌脂肪瘤影像特征及其相关病理基础。方法回顾性分析经手术及活组织穿刺病理证实的9例肝脏血管平滑肌脂肪瘤患者资料，3例同时行 CT 及 MR 检查，6例仅行 MR 检查。评价所有患者的影像及病理结果，分析其相关性。结果9例病灶均为单发。CT 示病灶呈不均匀低密度影，病灶内含部分脂质成分。增强扫描：3例呈不均匀轻度强化，门脉期及延迟扫描呈不均匀密度影，病变脂肪部分呈低密度影，血管部分呈高密度影，2例见假包膜强化。MR 示病变呈长 T1稍长 T2信号为主，4例 T2信号不均匀，3例可见短 T2流空信号，6例见大量脂质成分，2例病变内合并出血。8例行 MR 动态增强扫描，动脉期8例呈不均匀强化，强化程度为中到明显强化，门静脉期及延迟期扫描6例信号不均匀，3例以低信号为主，3例以高信号为主，4例见假包膜强化。MR 增强动脉期3例同时可见粗大供血动脉及引流静脉，5例仅见粗大供血动脉，7例病灶内见扭曲血管影。结论肝脏血管平滑肌脂肪瘤的影像特征与其病理组织特征密切相关，最终确诊有赖于病理。
목적：탐토간장혈관평활기지방류영상특정급기상관병리기출。방법회고성분석경수술급활조직천자병리증실적9례간장혈관평활기지방류환자자료，3례동시행 CT 급 MR 검사，6례부행 MR 검사。평개소유환자적영상급병리결과，분석기상관성。결과9례병조균위단발。CT 시병조정불균균저밀도영，병조내함부분지질성분。증강소묘：3례정불균균경도강화，문맥기급연지소묘정불균균밀도영，병변지방부분정저밀도영，혈관부분정고밀도영，2례견가포막강화。MR 시병변정장 T1초장 T2신호위주，4례 T2신호불균균，3례가견단 T2류공신호，6례견대량지질성분，2례병변내합병출혈。8례행 MR 동태증강소묘，동맥기8례정불균균강화，강화정도위중도명현강화，문정맥기급연지기소묘6례신호불균균，3례이저신호위주，3례이고신호위주，4례견가포막강화。MR 증강동맥기3례동시가견조대공혈동맥급인류정맥，5례부견조대공혈동맥，7례병조내견뉴곡혈관영。결론간장혈관평활기지방류적영상특정여기병리조직특정밀절상관，최종학진유뢰우병리。
Objective To explore the imaging manifestations of hepatic angiomyolipomas and its pathological results.Methods Nine patients with hepatic angiomyolipomas,who were confirmed by operation or biopsy pathology, were retrospectively analyzed.Three cases underwent CT and MR examination simultaneously,other 6 cases underwent MR examination alone.The correlation of imaging manifestations and pathological results of all the patients were analyzed.Results All the lesions of the 9 patients were single,CT scan showed that lesions were unevenly low density, and the value of CT showed that lesions contained lipid composition.Enhanced CT scan showed that 3 cases presented unevenly mild reinforcement,portal phase and delayed scan showed uneven density with fat part of the lesions as low density and vascular section as high density,and reinforcement of pseudocapsule in 2 cases was also observed.MR scan showed a longer T1 and a litter longer T2 signal,T2 signals of 4 cases were uneven,short T2 flow void signal was observed in 3 cases,a lot of lipid composition was in 6 cases,and bleeding lesions were in 2 cases.Dynamic enhanced MR scan was performed in 8 cases.In arterial phase,moderately to significantly uneven reinforcement was observed in all patients.In portal venous phase and delayed phase,scanning signal was uneven in 6 cases,low signal was in 3 cases, high signal was in 3 cases,and pseudocapsule reinforcement was observed in 4 cases.In arterial phase of enhanced MR scan,feeding arteries and draining veins were observed simultaneously in 3 cases,only feeding arteries in 5 cases, distorted blood vessels in 7 cases.Conclusion The imaging manifestations of hepatic angiomyolipomas are closely related to its pathological features,while the ultimate diagnosis still depends on pathology.