CAJ | 학술논문

目的比较肝血管平滑肌脂肪瘤（HAML）与原发性肝细胞肝癌（HCC）的CT征象，提高HAML的CT诊断准确性。资料与方法回顾性分析经病理确诊的9例HAML及20例HCC患者的CT特点，包括病变部位、形态、大小、各期CT值、边缘、肝硬化情况、肿瘤内血管显示情况等。结果 CT平扫及增强扫描动脉期HAML平均CT值明显低于HCC（t=-2.885, P<0.05；t=-3.307, P<0.01），门静脉期CT值差异无统计学意义（t=-0.293, P>0.05）。HAML及HCC动脉期与平扫CT值差值差异无统计学意义（t=1.289, P>0.05），门静脉期与平扫CT值差值差异有统计学意义（t=2.516, P<0.05）。7例HAML显示中心血管影，3例HCC显示中心血管影；1例HAML出现假包膜，13例HCC出现假包膜。HAML与HCC在血管影及假包膜方面差异均有统计学意义（χ2=10.828、7.219, P<0.01）。结论 CT检查可以显示HAML的脂肪成分，增强扫描呈“快进慢出”强化模式，内有粗大血管影，无假包膜，藉此可以与HCC进行鉴别。
목적비교간혈관평활기지방류（HAML）여원발성간세포간암（HCC）적CT정상，제고HAML적CT진단준학성。자료여방법회고성분석경병리학진적9례HAML급20례HCC환자적CT특점，포괄병변부위、형태、대소、각기CT치、변연、간경화정황、종류내혈관현시정황등。결과 CT평소급증강소묘동맥기HAML평균CT치명현저우HCC（t=-2.885, P<0.05；t=-3.307, P<0.01），문정맥기CT치차이무통계학의의（t=-0.293, P>0.05）。HAML급HCC동맥기여평소CT치차치차이무통계학의의（t=1.289, P>0.05），문정맥기여평소CT치차치차이유통계학의의（t=2.516, P<0.05）。7례HAML현시중심혈관영，3례HCC현시중심혈관영；1례HAML출현가포막，13례HCC출현가포막。HAML여HCC재혈관영급가포막방면차이균유통계학의의（χ2=10.828、7.219, P<0.01）。결론 CT검사가이현시HAML적지방성분，증강소묘정“쾌진만출”강화모식，내유조대혈관영，무가포막，자차가이여HCC진행감별。
Purpose To compare the CT features of hepatic angiomyolipoma (HAML) and primary hepatocellular carcinoma (HCC) and improve diagnostic accuracy for HAML. Materials and Methods The CT findings of 9 patients with HAML confirmed pathologically and 20 patients with HCC were retrospectively analyzed in terms of lesion location, appearance, size, margin, CT value at each phase, cirrhosis and vessel presence inside tumor. Results Mean CT value on plain scan and at arterial phase on contrast enhanced scan of HAML was significantly lower than that of HCC (t=-2.885, P<0.05;t=-3.307, P<0.01). At portal vein phase, difference in CT value showed no statistic significance (t=-0.293, P>0.05). CT value on plain scan and at arterial phase of both HAML and HCC was not significantly different (t=1.289, P>0.05) whilst that at portal vein phase was significantly different (t=2.516, P<0.05). Central vessels were shown in 7 cases of HAML and 3 cases of HCC, pseudocapsule appeared in 1 case of HAML and 13 cases of HCC with statistical difference (χ2=10.828, 7.219;P<0.01). Conclusion CT scan of HAML reveals the component of fat and presents"fast in and slow out"pattern, large shadow of vessel and absence of capsule on contrast enhanced scan, which can be helpful in the differential diagnosis from HCCs.