15例肝脏血管平滑肌脂肪瘤的CT、MRI和US表现回顾性分析

目的 总结肝脏血管平滑肌脂肪瘤(HAML)患者临床CT、MRI和US的影像学特征，探讨CT、MR和US诊断HAML的价值。 方法 回顾性分析宁波市中医院2011年4月—2016年3月间收治的15例经手术或病理学检查确诊的HAML病例，分型讨论HAML患者CT、MRI和US的影像学特征，归纳和总结不同类型HAML患者的影像学特征。 结果 15例患者均行CT检查，5例行MRI检查，4例行US检查，1例同时行CT、MRI和US检查。肌瘤型(2例):CT、MRI扫描见微小少脂肪组织；US见不均质低回声。脂肪瘤型(5例):CT见弥漫性脂肪密度影，增强后见扭曲血管影；MRI的T₁WI、T₂WI呈高信号，增强后见动脉期轻度强化；US见高回声。血管瘤型(3例):CT可见低密度瘤体，内部部分钙化，增强后明显持续强化；MRI中T₁WI处为低信号，T₂WI处为中高信号。混合型(5例):CT见软组织密度影与脂肪密度影相互混杂，增强后脂肪组织未见强化；MRI的T₁WI、T₂WI为不均匀高信号；US见实性不均匀高回声。 结论 肝脏不同类型血管平滑肌脂肪瘤患者的CT、MRI和US影像学表现不同，临床可依据肿瘤内脂肪成分对患者进行分型诊断。 

CT,MRI and ultrasonography features of hepatic angiomyolipomas:an retrospective analysis of 15 cases

Objective To summarize CT,MRI and ultrasonography manifestations of hepatic angiomyolipomas(HAML),and investigate the application and value of CT,MRI and ultrasonography on HAML. Methods Total 15 cases of HAML confirmed by surgery or pierced pathology testing in our hospital from April,2011 to March,2016 were retrospective analyzed,the CT,MRI or ultrasonography features of HAML were typing discussed,the imaging features of different types of HAML were summarized. Results Fifteen patients underwent CT examination,5 patients underwent MRI examination,4 patients underwent US examination,and 1 patient underwent CT,MRI and US examination.Fibroids(2 cases):tiny little adipose tissue was seen in CT,MRI;inhomogeneous hypoechoic was seen in US.Lipoma type(5 cases):diffuse fat density was seen in CT,and twisted vascular shadow was senn after enhancement;high signal was seen in T₁WI,T₂WI of MRI,slight enhancement in the arterial phase was seen after enhancement;Hyperechoic was seen in US.Hemangioma type(3 cases):tumor density was seen in CT,internal partially calcified,significantly continuing enhanced after enhancement;low signal was seen in T₁WI of MRI,and high signal was seen in T₂WI.Mixed(5 cases):Intermixed signal of tissue density and fat density was seen in CT,no enhancement in fat after enhancement;inhomogeneous high signal was seen in T₁WI,T₂WI of MRI;solid uneven hyperechoic was seen in US. Conclusion CT,MR and ultrasound imaging features of different subtypes of HAML patients were different.The patients could be diagnosed based on the fat ingredient in tumor.