• 四川大學(xué)華西醫(yī)院放射科（成都，610041）;

【摘要】　目的　 探討肝臟血管平滑肌脂肪瘤（hepatic angiomyolipoma，HAML）的多層螺旋CT影像學(xué)表現(xiàn)特征及其與病理學(xué)基礎(chǔ)的相關(guān)性，以進(jìn)一步提高CT診斷的準(zhǔn)確性。　方法　 收集2008年11月-2010年12月經(jīng)手術(shù)病理證實(shí)的16例HAML患者。所有患者均行螺旋CT平掃及動(dòng)脈期、門(mén)脈期增強(qiáng)檢查，重點(diǎn)觀察HAML的分型及其相應(yīng)CT表現(xiàn)及影像-病理的相關(guān)性。　結(jié)果　 16例患者共20個(gè)病灶，19個(gè)為稍低密度病灶，其中11個(gè)病灶內(nèi)可見(jiàn)明顯的脂肪密度影；1個(gè)為稍高密度病灶。動(dòng)脈期所有病灶均有不同程度的強(qiáng)化表現(xiàn)，15個(gè)病灶內(nèi)可見(jiàn)到較明顯條狀及扭曲的血管影。門(mén)脈期15個(gè)病灶有持續(xù)強(qiáng)化。　結(jié)論　 多層螺旋CT能準(zhǔn)確反映HAML的分型及其病理特征，對(duì)臨床表現(xiàn)不典型患者的診斷和鑒別診斷有較大診斷價(jià)值。
【Abstract】　Objective　 To discuss the correlation between the features of multislice spiral CT results for hepatic angiomyolipoma (HAML) and their pathological basis, and to further improve the diagnostic accuracy through CT examination.　Methods　 Sixteen HAML patients diagnosed pathologically between November 2008 and December 2010 in our hospital were enrolled in our study. All patients underwent multi-slice spiral CT scanning of pre-and post-contrast arterial phase, and portal venous phase. Focus was put on observation of HAML types and their corresponding manifestations, and the correlation between CT imaging and the pathologic basis.　Results　 There were 20 lesions in the 16 patients. Among the 19 hypodense lesions, 11 were clearly seen with fat density shadow. One out of the 20 lesions showed as slightly hyperdense. On the arterial phase scanning, all lesions showed enhancement, and obvious vascular shadow could be seen in15 lesions. On the portal venous phase, 15 lesions continued to strengthen.　Conclusions　 Multi-slice spiral CT can accurately reflect the classification of HAML and its pathological features. It has a great value in the diagnosis and differential diagnosis of patients without typical clinical manifestations.

引用本文： 胡雅君,盧春燕,劉榮波,張薇薇. 肝臟血管平滑肌脂肪瘤的多層螺旋CT表現(xiàn)特征及其病理學(xué)基礎(chǔ). 華西醫(yī)學(xué), 2011, 26(11): 1680-1683. doi: 復(fù)制

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6. 　Basaran C, Karcaaltincaba M, Akata D, et al. Fat-containing lesions of the liver: cross-sectional imaging findings with emphasis on MRI[J]. AJR, 2005, 184(4): 1103-1110.
7. 　Prasad SR, Wang H, Rosas H, et al. Fat-containing lesions of the liver: radiologic-pathologic correlation[J]. Radiographics, 2005, 25(2): 321-331.
8. 　Hogemann D, Flemming P, Kreipe H. Correlation of MRI and CT Findings with Histopathology in Hepatic Angiomyolipoma[J]. Eur Radiol, 2001, 11(8): 1389-1395.
9. 　Yan F, Zeng M, Zhou K. et al. Hepatic angiomyolipoma: various appearances on two-phase contrast scanning of spiral CT[J]. Eur J Radiol, 2002, 41(1): 12-18.
10. 　奚政君, 張忠德, 成宇帆, 等. 小兒肝見(jiàn)間葉性錯(cuò)構(gòu)瘤8例臨床病例分析[J]. 臨床與實(shí)驗(yàn)病理學(xué)雜志, 2006, 22(2): 242-244.
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12. 　Dalle I, Sciot R, de Vos R, et al. Malignant angiomyolipoma of the liver: a hitherto unreported variant[J]. Histopathology, 2000. 36(5): 443-450.
13. 　Guidi G, Catalano O, Rotondo A. Spontaneous Rupture of a Hepatic Angiomyolipoma CT Findings and Literature Review[J]. Eur Radiol, 1997, 7(3): 335-337.
14. 　Groquet V, Pilette C, Aube C, et al. Late recurrence of a hepatic angiomyolipoma[J]. Eur J Gastroenterol Hepatol, 2000, 12(5): 579-582.
15. 　Ding GH, Liu Y, Wu MC, et al. Diagnosis and treatment of hepatic angiomyolipoma[J]. J surg oncol, 2011, 103(8): 807-812.
  1. 1. 　Okuda K, Peters RL. Hepatocellular carcinoma[M]. New York: John Wiley & Sons, 1976: 247-307.
  2. 2. 　Tsui WMS, Colombari R, Portmann BC, et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants[J]. Am J Surg Pathol, 1999, 23(1): 34-48.
  3. 3. 　Mongha R, Bansal P, Dutta A, et al. Wunderlich’s syndrome with hepatic angiomyolipoma in tuberous sclerosis[J]. Indian J Cancer, 2008, 45(2): 64-66.
  4. 4. 　Nonomura A, Mizukami Y, Kadoya M. Angiomyolipoma of the liver: a collective review[J]. J Gastroenterol, 1994, 29(1): 95-105.
  5. 5. 　Li T, Wang L, Yu HH, et al. Hepatic angiomyolipoma: a retrospective study of 25 cases[J]. Surg Today, 2008, 38(6): 529-535.
  6. 6. 　Basaran C, Karcaaltincaba M, Akata D, et al. Fat-containing lesions of the liver: cross-sectional imaging findings with emphasis on MRI[J]. AJR, 2005, 184(4): 1103-1110.
  7. 7. 　Prasad SR, Wang H, Rosas H, et al. Fat-containing lesions of the liver: radiologic-pathologic correlation[J]. Radiographics, 2005, 25(2): 321-331.
  8. 8. 　Hogemann D, Flemming P, Kreipe H. Correlation of MRI and CT Findings with Histopathology in Hepatic Angiomyolipoma[J]. Eur Radiol, 2001, 11(8): 1389-1395.
  9. 9. 　Yan F, Zeng M, Zhou K. et al. Hepatic angiomyolipoma: various appearances on two-phase contrast scanning of spiral CT[J]. Eur J Radiol, 2002, 41(1): 12-18.
  10. 10. 　奚政君, 張忠德, 成宇帆, 等. 小兒肝見(jiàn)間葉性錯(cuò)構(gòu)瘤8例臨床病例分析[J]. 臨床與實(shí)驗(yàn)病理學(xué)雜志, 2006, 22(2): 242-244.
  11. 11. 　徐賽英. 實(shí)用兒科放射診斷學(xué)[M]. 北京: 北京出版社, 1999: 632.
  12. 12. 　Dalle I, Sciot R, de Vos R, et al. Malignant angiomyolipoma of the liver: a hitherto unreported variant[J]. Histopathology, 2000. 36(5): 443-450.
  13. 13. 　Guidi G, Catalano O, Rotondo A. Spontaneous Rupture of a Hepatic Angiomyolipoma CT Findings and Literature Review[J]. Eur Radiol, 1997, 7(3): 335-337.
  14. 14. 　Groquet V, Pilette C, Aube C, et al. Late recurrence of a hepatic angiomyolipoma[J]. Eur J Gastroenterol Hepatol, 2000, 12(5): 579-582.
  15. 15. 　Ding GH, Liu Y, Wu MC, et al. Diagnosis and treatment of hepatic angiomyolipoma[J]. J surg oncol, 2011, 103(8): 807-812.