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1、MR对含脂质肝肿瘤的诊断价值CharacterizationofHepaticTumorsContainedLipid:MRImagingFindings[摘要]目的评估MRI对含脂质肝肿瘤的诊断价值。方法回顾性分析了经病理证实的34例含脂质肝肿瘤的MRI表现和术前或穿刺前诊断。结果T
2、WI上32例呈高信号、2例低信号，T?WI上32例呈高信号、1例等信号、1例低信号。用脂肪抑制后，15例肝细胞癌、7例血管平滑肌脂肪瘤、1例肝腺瘤和1例局灶结节性增生(1个病灶)在T]WI上的高信号完全消失，1例不典型腺瘤样增生
3、结节伴局灶癌变和1例血管平滑肌脂肪瘤伴出血和囊变在T]WI上的高信号大部分消失，6例肝腺瘤和1例局灶结节性增生(1个病灶)在T
4、WI上的髙信号无变化。24例血供丰富，4例血供不丰富。术前或穿刺前诊断：14例肝细胞癌、2例腺瘤、7例血管平滑肌脂肪瘤和1例局灶结节性增生诊断正确，2例血管平滑肌脂肪瘤诊断为良性肿瘤。1例肝细胞癌误诊为血管平滑肌脂肪瘤，1例不典型腺瘤样增生结节伴局灶癌变误诊为不典型腺瘤样增生结节，1例肝腺瘤误诊为局灶结节性增生，4例腺瘤和1例血管平滑肌脂肪瘤伴出血和囊变误诊为肝癌。结论MRI能显示含脂
5、质肝肿瘤的特征性表现，对多数这类肿瘤术前或穿刺前能正确诊断。[关键词]含脂质的肝肿瘤；磁共振成像[Abstract]ObjectiveToevaluatetheusefulnessofMRimagingincharacterizationofhepatictumorscontainedlipid・MethodsTheMRimagingfeaturesanddiagnosisof34caseshepatictumorscontainedlipidprovedpathologicallywereretrospect
6、ivelyreviewed.ResultsThirty-twolesionswerehyper-intenseandtwolesionshypointenseonT]WI,andthirty-twolesionswerehyperintenseandoneisointenseandonehypointenseonT2WI.Thehighsignalintensitywithinfifteenhepatocellularcarcinomas(HCCs),andsevenhepaticangiomyolipomas
7、(HAMLs),andonefocalnodularhyperplasis(FNH)onT
8、W【disappearedcompletelyafterusingfatsuppression.MostpartofthehighintensitywithinonedysplasticnodulewithfocalHCC,andoneHAMLwithhemorrhageandcysticchangeonT
9、WIdisappeared,andthehighsignalofsixhepaticadenomasandoneF
10、NHremainedunchangedafterusingfatsuppression.Twenty-fourlesionswerehyper-vascularandfourhypovascukir.Preoperativeorprebiopsydiagnosis:fourteenHCCs,twoadenomas,sevenHAMLsandoneFNHwerediagnosedcorrectlyandtwoHAMLswerediagnosedasbenigntumors.OneHCCwasmistakenfor
11、angiomyolipoma,onedysplasticnodulewithfocalHCCmistakenfordysplasticnodule,oneadenomamistakenforENH,andfouradenomasandoneHAMLwithhemorrhageandcysticchangemistakenforHCCs.ConelusionMRimagingcanrevealthecharacteristicfindingsofhepatictumorscontainedlipidandaccu
12、ratepreoperativeorprebiopsydiagnosisinmostofthosetumorscanbemade.[Keywords]Liver;fattytumor;Magneticresonanceimaging确认肝肿瘤屮含有脂质成分对缩小鉴别诊断范围十分重要。磁共振成像(MRI)的脂肪抑制技术对肝肿瘤中脂质成分的发现与定性诊断具有高度的敏感性和特界性。国内外系统
