肝腺瘤的CT及MRI表现及误诊分析-陈鹏

CTandMRIappearancesandthecausesofmisdiagnosisofhepaticadenomaCHENPeng,ZHAOWei-dong＊,ZHANGHong-yu,QINHui-juan,LIUShuai(DepartmentofMedicalImaging,theSecondHospitalofShanxiMedicalUniversity,Taiyuan030001,China)[Abstract]　Objective　ToretrospectivelyanalyzeCTandMRappearancesofhepaticadenoma,andtostudythecausesofmisdiagnosiswithreviewofrelativeliteratures.Methods　CTandMRIdataof8patientswithpathologicallyconfirmedhe-paticadenomawereretrospectivelyanalyzed.Pre-andpost-contrasttri-phase(arterial,portalvenousanddelayed)CTscansandroutineMRscanwereperformedinall8patients,andprotonmagneticresonancespectroscopy(1H-MRS)wasperformedin2patients.Results　Typicaldemonstrationswerefoundin4patientswhowerecorrectlydiagnosed.Amongtheotherswithatypicalfindings,3patientsweremisdiagnosedaslivercancerand1asfocalnodularhyperplasia(FNH).The1H-MRScurvesof2adenomatumorshowedthatthepeakofcholineoftumortissuehadnosignificantdifferencecom-paringwiththatofnormallivertissuearoundthetumortissue.Conclusion　CTandMRIfindingsofhepaticadenomashavesomecharacteristics,butatypicalmanifestationsleadtomisdiagnose.1H-MRSmaybehelpfulforthedifferentialdiagnosisofhepaticadenoma.[Keywords]　Adenoma,livercell;Diagnosticimaging;MisdiagnosisCTMRI陈　鹏,赵卫东＊,张红宇,秦慧娟,刘　帅(,　030001)[　]　　CT、MRI,。　8CTMRI。CT(、、);MR,2(1H-MRS)。　8,4,;4,3,1(FNH)。21H-MRS。　CTMRI,。1H-MRS。[]　,;;[]　R445;R735.7　[]　A　　[]　1672-8475(2010)02-0124-04[](1982-),,,,。:。E-mail:[e-mail][],,030001。E-mail:[e-mail][]2009-08-10　　[]2009-11-21　　,[1],。CTMRI;,,[2]。8CTMRI,,[2-10],。1　1.1　8,2,6,20～40,27。2,6,。,,·124·201072　ChinJIntervImagingTher,2010,Vol7,No2DOI:10.13929/j.1672-8475.2010.02.027AFP25μg/L。3,。1.2　CTGELightSpeed16CT,、、,3ml/s100ml,25s60s,2～3min。:120kV,250mA,7.5mm,7.5mm。MRGESignaEXCITE1.5THDTwinSpeed,,,T2WIFSE(TR/TE6667ms/84.7ms,NEX2,FOV38cm×38cm,288×224),T1WI2D(fastspoiledgradientre-called,FSPGR)(TR/TE205ms/1.2ms,NEX1,FOV38cm×38cm,288×160),、(TR/TE180ms/2.3ms,NEX1,FOV38cm×38cm,288×170)。2(protonMRspectros-copy,1H-MRS),T2WI,probe-SE1H-MRS。:TR/TE3750ms/35ms,NEX8,FOV40cm×40cm,(regionofinterest,ROI)2cm×2cm×2cm。,3min30s。ROI,、、。2　　　8,,2～6cm,6,2·125·201072　ChinJIntervImagingTher,2010,Vol7,No23　MRS　A、B()1H-MRS;C、D()1H-MRS。(B)(D);6。　　84,:CT(3)(1),1“”。,2;,;(1)。MRT1WI(3)(1),T2WI(4,2),1,2()。　　4,3CT,“”,MRT1WI,T2WI,;1,(focalnodularhyperplasia,FNH)。21H-MRS,(3)。3　　　,,,、、[3]。80%,20%。[4],。,。8,6,2,,(3),。　　,CTMRI。[5-7],CT,、;,,“”,,;、,,。,,,,,。MR,T1WI、T2WI,、[8-9]。4,。　　、FNH。CTMRI,、FNH,。、,AFP,CTMRI“”,。FNH,,,,MRI,T2WI,CT,·126·201072　ChinJIntervImagingTher,2010,Vol7,No2,,。1H-MRS,[10],,,,、。21H-MRS,,,,,。1H-MRS,。　　,。84,3,1FNH,50.00%。:①:,;,、,,。4,;②:3CT“”,;1,FNH,FNH。　　,,,;,1H-MRS。[][1]　,,.CTMRI.,2005,21(1):80-82.[2]　,.CT.,2007,35(6):892-893.[3]　ChungKY,Mayo-SmithWW,SainiS,etal.Hepatocellularade-noma:MRimagingfeatureswithpathologiccorrelation.AJRAmJRoentgenol,1995,165(2):303-308.[4]　IchikawaT,FederleMP,GrazioliL,etal.Hepatocellularadeno-ma:multiphasicCTandhistopathologicfindingsin25patients.Radiology,2000,214(3):861-868.[5]　,,,..,2007,23(12):1636-1639.[6]　,,,.MRI.,2006,40(1):194-197.[7]　,,,.CT.,2007,22(3):277.[8]　,,,.MRIMRI.,2008,16(6):415-418.[9]　,,,..,2004,20(5):291-292.[10]　LiCW,KuoYC,ChenCY,etal.QuantificationofcholinecompoundsinhumanhepatictumorsbyprotonMRspectroscopyat3T.MagnResonMed,2005,53(4):770-776.《中国医学影像技术》引证报告　　2009()1868,2008《》、:1　2371,。2　0.550,。3　59.8,。4　0.80。5　0.84。·127·201072　ChinJIntervImagingTher,2010,Vol7,No2