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目的 描述肝腺瘤的超声 (US)、CT和MRI表现与病理基础 ,探讨综合影像对肝腺瘤的诊断价值。方法 回顾性分析经手术切除、病理证实的 6例肝腺瘤的US、CT和MRI表现 ,并与病理所见对照。结果 6例肝腺瘤均为单发肿块 ,1例术前综合影像诊断为肝腺瘤 ,4例误诊为肝癌 ,1例误诊为肝局灶结节性增生。US :6例呈稍低或低回声 ,4例有低回声晕 ,彩色多普勒显示 6例肿块内有较丰富的门脉样血流和低速动脉样血流。CT :6例为稍低或低密度 ,4例有假包膜 ,4例动脉期、门脉期均轻度强化 ,1例动脉期中度强化、门脉期轻度强化。MRI:T1WI和T2 WI上 ,6例表现为以高信号为主的混杂信号 ,用脂肪抑制后T1WI上的高信号无变化 ;2例动脉期显著强化、门脉期和延迟期轻度强化 ,3例动脉期、门脉期和延迟期均轻度强化。 6例均有假包膜 ,且在门脉期或延迟期出现轻度强化。结论 肝腺瘤的综合影像表现缺乏特异性。对有假包膜和混杂高信号 (用脂肪抑制后T1WI上的高信号无变化 )的多血供肿块应考虑到肝腺瘤的诊断
Objective To describe the ultrasonographic (US), CT and MRI manifestations and pathological basis of hepatic adenoma and to explore the diagnostic value of comprehensive imaging in hepatic adenoma. Methods We retrospectively analyzed the US, CT and MRI findings of 6 cases of hepatic adenomas confirmed by surgery and pathology, and compared them with the pathological findings. Results All the 6 cases of hepatic adenomas were single mass. One case was diagnosed as hepatic adenoma by comprehensive preoperative imaging, the other 4 cases misdiagnosed as hepatocellular carcinoma and one case was misdiagnosed as focal nodular hyperplasia. US: 6 cases were slightly lower or hypoechoic, 4 cases had hypoechoic, color Doppler showed six cases of tumor mass within the portal vein blood flow and arterial blood flow. CT: 6 cases were slightly lower or lower density, 4 cases had pseudocapsule, 4 cases of arterial phase, mild portal phase enhancement, 1 case of moderate enhancement of arterial phase and mild enhancement of portal phase. MRI: T1WI and T2WI, 6 cases showed high signal-based mixed signal with fat suppression after T1WI high signal did not change; 2 cases of arterial phase was significantly enhanced portal phase and delayed mild enhancement, Three cases of arterial phase, portal phase and delayed phase were slightly enhanced. All of the 6 cases had pseudocapsules with slight enhancement in portal or delayed phase. Conclusions Hepatic adenomas have a lack of specificity for comprehensive imaging. The diagnosis of hepatic adenoma should be considered for the presence of multiple blood donors with pseudocapsules and mixed high signals (no change in high signal on T1WI after fat suppression)