CAJ | 학술논문

目的：探讨MRI检查对肝腺瘤的诊断价值。方法：回顾性分析经病理证实的15例肝腺瘤患者的MRI表现、ADC值的观测和术前或活检前的诊断，并与病理结果进行对照。结果：14例患者术前诊断考虑肝腺瘤，1例考虑肝腺瘤或局灶性结节样增生（FNH）。15例中1例为多发（9个病灶），2例为2个病灶，其余12例均为单发，共25个病灶；T1 WI上22个病灶呈低或稍低信号，3个病灶呈稍高信号；T2 WI上15个病灶呈高信号，10个病灶呈低信号；DWI 示16个病灶呈稍高信号，9个病灶呈等信号；双回波序列上24个病灶内有不同程度的脂质成分；6个病灶有瘤内出血。Gd-DTPA 增强扫描：动脉期25个病灶呈中度到明显强化；门脉期18个病灶呈稍低信号，7个病灶呈稍高信号；延迟扫描18个病灶呈低信号，7个病灶呈等信号；9个病灶可见假包膜样强化，16例未见明确假包膜样强化。DWI扫描测量17个病灶[12例单发病灶、2例2个病灶及1例多发病灶（测量最大病灶）]的 ADC值为（1．696±0．243）×10-3mm2/s，周围正常肝实质ADC值为（1．345±0．243）×10-3mm2/s，病灶与周围正常肝实质 ADC 值的比值＞1。结论：MRI 检查及 ADC 值测量为肝腺瘤的无创性诊断提供了更准确的依据。
목적：탐토MRI검사대간선류적진단개치。방법：회고성분석경병리증실적15례간선류환자적MRI표현、ADC치적관측화술전혹활검전적진단，병여병리결과진행대조。결과：14례환자술전진단고필간선류，1례고필간선류혹국조성결절양증생（FNH）。15례중1례위다발（9개병조），2례위2개병조，기여12례균위단발，공25개병조；T1 WI상22개병조정저혹초저신호，3개병조정초고신호；T2 WI상15개병조정고신호，10개병조정저신호；DWI 시16개병조정초고신호，9개병조정등신호；쌍회파서렬상24개병조내유불동정도적지질성분；6개병조유류내출혈。Gd-DTPA 증강소묘：동맥기25개병조정중도도명현강화；문맥기18개병조정초저신호，7개병조정초고신호；연지소묘18개병조정저신호，7개병조정등신호；9개병조가견가포막양강화，16례미견명학가포막양강화。DWI소묘측량17개병조[12례단발병조、2례2개병조급1례다발병조（측량최대병조）]적 ADC치위（1．696±0．243）×10-3mm2/s，주위정상간실질ADC치위（1．345±0．243）×10-3mm2/s，병조여주위정상간실질 ADC 치적비치＞1。결론：MRI 검사급 ADC 치측량위간선류적무창성진단제공료경준학적의거。
Objective:To study the significance of MRI and ADC value measurement in the diagnosis of hepatic adeno-ma.Methdos:MRI findings and ADC value of 15 cases with hepatic adenoma before surgery or biopsy were retrospectively analyzed and correlated with pathology.Resluts:The preoperative diagnosis was hepatic adenoma (14 patients),hepatic ade-noma or FNH (1 patient).Of the 15 patients,there were multiple lesions (1 patient with nine lesions),two lesions (2 pa-tients),and the remaining 12 patients had single lesion,with a total of 25 lesions.On T1 WI,22 lesions showed hypo- or slightly hypo-,3 lesions showed slightly hyper-signal intensity.On T2 WI,15 lesions showed hyper-,10 lesions showed hypo-signal intensity.On diffusion weighted imaging (DWI),16 lesions showed slightly hyper-,9 lesions showed iso-intensity.24 lesions had various degree of lipid composition and 1 lesion without lipid in double echo sequence.Intumoral hemorrhage could be assessed in 6 lesions whereas no hemornhage in 19 lesions.After Gd-DTPA enhancement,25 lesions showed mod-erate to marked enhancement in arterial phase,18 lesions showed slightly hypo-,7 lesions showed slightly hyper-intensity in portal phase and 18 lesions showed hypo-,7 lesions iso- intensity in delayed phase.Pseudocapsule enhancement could be re-vealed in 9 lesions while no enhancement in 16 cases.On DWI,the mean apparent diffusion coefficient (ADC)value was (1.696±0.243)×10-3mm2/s (single lesion,n= 12;2 lesions,n= 2;multiple lesions,n= 1,with a total of 17 lesions.Of the multiple lesions,the largest lesion was measured).The ADC value of the surrounding normal liver parenchyma was (1.345±0.243)×10-3 mm2/s,with the ratio of lesion to surrounding normal liver parenchyma>1.Conclusion:MRI with ADC value measurement provides a valuable approach for the non-invasive diagnosis of hepatic adenoma.