CAJ | 학술논문

目的：探讨肝脏上皮样血管平滑肌脂肪瘤的CT、MR表现及其病理学基础。方法对9例经病理及免疫组化证实的EAML患者的临床、CT、MRI表现及病理特征行回顾性分析。结果9例患者(2名男性和7名女性)中5例行CT扫描，4例行MR扫描。9例均为单发病灶，平扫呈不均匀软组织肿块，3例见脂肪灶，增强扫描动脉期病灶均表现为明显强化，门脉期和(或)延迟期5例强化程度减退，呈“快进快出”表现，3例强化程度高于或等于肝实质，呈“快进慢出”表现，1例部分强化程度减退，部分呈延迟强化。其中7例内见紊乱的肿瘤血管，9例均见不同程度的引流静脉早期显影，1例见假包膜，并呈延迟强化。结论 EAML表现为含少量或不含脂肪成分的富血供肿瘤，脂肪灶的检出、引流静脉早期显影及特征性强化方式有助于此病的诊断。
목적：탐토간장상피양혈관평활기지방류적CT、MR표현급기병이학기출。방법대9례경병리급면역조화증실적EAML환자적림상、CT、MRI표현급병리특정행회고성분석。결과9례환자(2명남성화7명녀성)중5례행CT소묘，4례행MR소묘。9례균위단발병조，평소정불균균연조직종괴，3례견지방조，증강소묘동맥기병조균표현위명현강화，문맥기화(혹)연지기5례강화정도감퇴，정“쾌진쾌출”표현，3례강화정도고우혹등우간실질，정“쾌진만출”표현，1례부분강화정도감퇴，부분정연지강화。기중7례내견문란적종류혈관，9례균견불동정도적인류정맥조기현영，1례견가포막，병정연지강화。결론 EAML표현위함소량혹불함지방성분적부혈공종류，지방조적검출、인류정맥조기현영급특정성강화방식유조우차병적진단。
Objective To investigate the imaging and pathologic characteristics of hepatic epithelioid angiomyolipoma (EAML). Methods Clinical features, CT and MR characteristics, and pathological findings of 9 patients with EAML proved by pathology and immunohistochemistry were analyzed retrospectively. Results There were 7 female and 2 male patients. 5 patients underwent abdominal CT scan, 4 patients underwent abdominal MR scan. All of the mass were solitary, low fat content was found in 3 cases. EAML was predominantly hypoattenuating/isoattenuating to liver or hypointense on T1WI, hyperintense on T2WI on unenhanced images. At hepatic arterial phase, the masses were heterogeneously hyperattenuating in all patients. In the portal venous and delayed phase,5 lesions appeared as quick-in and quick out enhanced mode, 3 lesions appeared as quick-in and slow-out enhanced mode,1 lesion appeared as quick-in and quick out partly and quick-in and slow-out partly. Enlarged malformation or filiform vessels in the center or around the tumors were noted in 7 patients. The early draining veins were noted in all patients. Late enhancement of a discrete capsule was observed in one mass. Conclusion EAML usually presents as a low fat content and rich blood supply tumor. The presence of fat content, early draining vein and characteristic enhanced mode are helpful for the diagnosis of HAML.