MRI表现及ADC值对肝腺瘤的诊断意义

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；T，WI上22个病灶呈低或稍低信号，3个病灶呈稍高信号；T2WI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^-3mm^2／s，周围正常肝实质ADC值为（1．345±0．243）×10^-3mm^2／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。

The significance of MRI and ADC value measurement in the diagnosis of hepatic adenoma

Objective：To study the significance of MRI and ADC value measurement in the diagnosis of hepatic adeno- ma. Methdos： MRI findings ahd ADC value of 15 cg.ses with hepatic adenoma before surgery or biopsy were retrospectively analyzed and correlated with pathology. Resluts：The＇ preoperative diagnosis was hepatic adenoma （14 patients）, hepatic adeno.maor FNH （1 patient）. Of the 15 patients,there were multiple lesions （1 patient with nine lesions） ,two lesions （2 patients） ,and the remaining 12 patients had single lesion, with a total of 25 lesions. On T1WI, 22 lesions showed hypoor slightly hypo-, 3 lesions showed slightly hypersignal 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 hype~intensity in portal phase and 18 lesions showed hypo-,7 lesions iso- intensity in delayed phase. Pseudocapsule enhancement could be revealed in 9 lesions while no enhancement in 16 cases. On DWI, the mean apparent diffusion coefficient （ADC） value was （1. 696±0. 243） ）〈 10^-3mm^2/s （single lesion,n= 12;2 lesions,n=2 ;multiple lesions,n= 1,with a total of 17 lesions. Of the multiple lesion~, the largest lesion was measured）. The ADC value of the surrounding normal liver parenchyma was （1. 345±0. 243））〈 10^-3 mm^2/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.