肝样腺癌CT及MRI表现

目的 观察肝样腺癌(HAC)CT及MRI表现。方法 收集10例经手术(n=9)或穿刺活检(n=1)病理证实的HAC患者，其中9例接受CT平扫及增强检查，1例直肠HAC接受平扫及增强MR检查，观察其影像学表现。结果 10例HAC中，5例位于消化道(胃3例、食管1例、直肠1例),2例位于前纵隔，位于胸壁及腹壁皮肤、胆囊及卵巢各1例；9例为单发病灶，1例(序号8)2个病灶分别位于胸壁及腹壁皮肤；5个消化道病灶表现为胃壁、食管壁或肠壁不均匀增厚，边界不清；6个前纵隔、胸壁及腹壁皮肤、胆囊或卵巢HAC均表现为软组织密度病灶，5个边界较清、1个边界不清。CT/MR增强后7个病灶呈轻度不均匀强化，3个呈不均匀延迟强化，1个呈不均匀明显强化。结论 HAC的CT及MRI表现具有一定特征性。

CT and MRI manifestations of hepatoid adenocarcinoma

Objective To observe CT and MRI manifestations of hepatoid adenocarcinoma (HAC). Methods Ten patients with HAC confirmed by operation (n=9) or puncture biopsy (n=1) pathology were enrolled. Nine patients underwent plain and enhanced CT scanning, while 1 patient (rectal HAC) underwent plain and enhanced MR scanning. Then imaging manifestations of HAC were analyzed. Results Among 10 cases of HAC, the lesions located in digestive tract in 5 cases, including 3 cases in stomach, 1 cases in esophagus and 1 case in rectum, while in anterior mediastinum in 2 cases, and in each 1 case in chest and abdominal wall skin, gallbladder and ovary, respectively. Single HAC lesion was detected in 9 cases, while 1 case (No.8) was found with 2 lesions located in chest and abdominal wall skin. Totally 5 lesions located in digestive tract present as esophagus, stomach or intestinal wall unevenly thickened with unclear boundaries, and 6 lesions in anterior mediastinum, chest and abdominal wall, gallbladder and ovary HAC (6 lesions in total) showed soft tissue density, 5 with clear boundaries and 1 with unclear boundary. On enhanced CT/MR scanning, mild uneven enhancement was found in 7 lesions, while uneven delayed enhancement and uneven significantly enhanced was noticed in 3 and 1 lesion, respectively. Conclusion CT and MRI manifestations of HAC had certain characteristics.