肝脏上皮样血管平滑肌脂肪瘤MRI影像特征分析.pdfVIP

浙江临床医学2025年3月第27卷第3期·421·

·检测诊断·

肝脏上皮样血管平滑肌脂肪瘤MRI影像特征分析

张宾葛晓莉陈琳殷洁潘江峰*

【摘要】目的探讨肝脏上皮样血管平滑肌脂肪瘤（HEAML）的MRI影像表现。方法回顾性分析经手术病理证实的12例HEAML患者

的影像资料，总结MRI特征性表现。结果10例患者单发，2例患者多发，共14例病灶，术前6例诊断正确，4例误诊为肝细胞肝癌，2例误诊

为肝腺瘤，1例误诊为FNH，1例误诊为肝血管平滑肌脂肪瘤。MRI平扫TWI多为不均匀高信号或稍高信号，TWI低信号，DWI高或高低混

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杂信号，ADC为等或稍低信号，化学位移成像反相位较同相位局部信号减低；增强扫描强化方式4例病灶“快进快出”，10例病灶“快进慢

出”，9例病灶内部显示“中心血管征”。8例病灶显示供血动脉，9例病灶显示动脉期早显引流静脉，4例病灶见持续性强化假包膜。4例患者

伴发肾脏AML。结论HEAML的MRI影像表现有一定的特征性，MRI多序列成像及动态增强扫描对其诊断及鉴别诊断有重要价值。

【关键词】上皮样血管平滑肌脂肪瘤肝脏磁共振成像

【Abstract】ObjectiveToinvestigatethemagneticresonanceimaging(MRI)findingsandmisdiagnosisanalysisofhepaticepithelioid

angiomyolipoma(HEAML),soastoimprovethepreoperativediagnosisofthisdisease.MethodsTheimagingdataof12patientswithHEAMLconfirmed

bysurgeryandpathologyinourhospitalwereretrospectivelyanalyzed,andtheirMRIfindingsweresummarized.ResultsTherewere14lesionsin10

patientswithsinglelesionand2patientswithmultiplelesions.Thepreoperativediagnosiswascorrectin6cases,4casesweremisdiagnosedashepatocellular

carcinoma,2casesweremisdiagnosedashepaticadenoma,1casewasmisdiagnosedasfocalnodularhyperplasia(FNH),and1casewasmisdiagnosedashepatic

angiomyolipomaAML.OnTWIofMRIplainscan,mostofthesignalswereunevenhighsignalorslightlyhighsignal,lowsignalonTWI,highormixedhigh

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andlowsignalonDWI,andequalorslightlylowsignalonADC.Thereversephaseofchemicaldisplacementimagingwaslowerthanthelocalsignalinthe

samephase;Theenhancementmodeofenhancedscanningwasfastinandfastou