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| 1 | 肝脏血管平滑肌脂肪瘤的诊断和治疗显示文摘目的分析并总结肝脏血管平滑肌脂肪瘤(AML)的临床表现和诊断,探讨其治疗策略。方法对1992-2006年第二军医大学东方肝胆外科医院手术病理证实的79例肝AML临床资料进行回顾性分析研究,总结其诊治经验。结果患者女58例,男21例。发病年龄17~69岁,平均(43±8.14)岁,均无合并肾血管平滑肌脂肪瘤或结节性硬化症。有临床症状者25例。肿瘤大小1.0~25cm,平均(6.1±4.08)cm,均为单发肿瘤。肝右叶53例,左叶22例,尾状叶4例。术前正确诊断者41例(52%)。自发性破裂出血1例。79例均手术切除,无手术死亡或严重并发症。术后随访3~13年,1例术后6年复发,1年后死亡。结论肝血管平滑肌脂肪瘤无特异性临床症状,综合影像学检查有助于术前正确诊断,但鉴别诊断困难,特别是对直径小于5cm的肿瘤术前难以确诊。最终诊断依赖于病理组织学检查和HMB-45免疫组化染色。手术切除是治疗肝血管平滑肌脂肪瘤的安全、有效方法。应警惕潜在恶性和自发性破裂出血可能,一旦诊断明确宜尽早手术,术后应密切随访。 | 丁光辉 吴孟超 杨广顺 杨甲梅 丛文铭 | 2010 | 第二军医大学学报2010，31，6： | 20 |
| 2 | 肝脏血管平滑肌脂肪瘤的CT及MRI影像特征显示文摘目的 分析肝脏血管平滑肌脂肪瘤(HAML)的CT和MRI影像学特征,进一步提高HAML诊断正确率.方法 回顾分析18例经手术病理证实的肝脏血管平滑肌脂肪瘤的影像学特点.其中12例行CT平扫及增强检查,10例行MRI平扫及增强检查,4例行两类检查.总结并分析病灶数目、大小、位置、形态、影像学平扫及增强特点.结果 18例单发HAML直径为1.5~17.2 cm(平均5.3 cm).平扫结果显示5例有脂肪成分,1例有出血坏死.增强后,5例表现为“快进快出”强化模式,11例表现为“快进慢出”模式,2例表现为无规律斑片、网线状强化.有11例可见供血动脉(均来自肝动脉),12例可见肿瘤内血管,4例可见肿瘤早期引流静脉(3例引流至肝静脉、1例引流至门静脉),1例出现延迟期假包膜强化.结论CT和MRI平扫及增强能够显示HAML的影像学特征,结合 无肝硬化背景、AFP正常以及肿瘤无包膜、富血供、伴有供血动脉和肿瘤内血管等影像学特点有助于HAML的诊断. | 周洁洁 许化致 周晓军 李建策 木国柱 | 2016 | 中华肝胆外科杂志2016，22，2： | 18 |
| 3 | Multi-slice computed tomography manifestations of hepatic epithelioid angiomyolipoma显示文摘AIM:To explore the characteristics of multi-slice computed tomography(CT)manifestations of hepatic epithelioid angiomyolipoma(HEA),improve the rate of accurate diagnosis,and reduce the misdiagnostic rate.METHODS:The multi-slice CT manifestations in five patients who were diagnosed with HEA definitely by postoperative pathological examination were analysed retrospectively.Three female patients and two male patients were included.Before operation,four patients received plain CT scanning and dynamic enhancement scanning,and the other patient only received enhancement scanning,with immunohistochemical analysis conducted after postoperative pathological examination.Four patients were misdiagnosed by CT,including three patients misdiagnosed with hepatic cell carcinoma and one patient with focal nodular hyperplasia.RESULTS:Upper abdominal multi-slice spiral CT scanning and three-stage enhancement scanning were conducted in five patients with HEA before operation.HEA had certain characteristic CT manifestations:low density masses,a few relatively high-density masses or fatdensity masses diffusely shown in foci,clear boundary,round or oval and large focus,and tumour size ranging from 3.1 cm×2.5 cm to 7.0 cm×5.2 cm.During enhancement scanning,the foci were significantly enhanced uniformly or non-uniformly during the arterial phase,while during the venous and equilibrium phases,the foci were enhanced continuously or showed obvious low-density masses.Obviously enhanced and widened vessels could be found adjacent to foci or in the central area of foci during the arterial phase.CONCLUSION:CT manifestations of HEA have certain characteristics.Primary diagnosis can be obtained by combining CT findings with clinical data,but pathological examination is still needed for a definite diagnosis. | Chun-Lai Dai Li-Ping Xue Yu-Mei Li | 2014 | World Journal of Gastroenterology2014，20，12： | 15 |
| 4 | 肝脏上皮样血管平滑肌脂肪瘤的MRI表现显示文摘目的探讨肝脏上皮样血管平滑肌脂肪瘤(EAML)的MRI表现。方法回顾性分析2010年6月至2011年7月经手术病理及免疫组织化学证实的8例肝脏EAML患者资料,分析其影像特点,包括病灶的分布、信号强度、血供、病灶内的血管、病灶的供血动脉和引流静脉、脂肪、出血和坏死囊变的存在以及假包膜等,并与病理结果对照。结果8例患者均为单发病变,呈长T1、长T2信号,DWI为高信号,6例T2WI信号不均匀,其中1例见少量脂肪,3例合并出血。MR动态增强扫描,动脉期8例均呈中度或明显强化,其中6例强化不均匀,2例均匀,门静脉期及延迟期病灶强化程度有所减退,但信号仍高或稍高于周围肝实质。MR增强动脉期4例同时可见粗大供血动脉及引流静脉,1例仅见引流静脉,1例仅见粗大供血动脉。7例病灶内见扭曲血管影。结论MR检查可显示肝脏EAML的影像特征,病灶的供血动脉和引流静脉以及病变内扭曲血管影的显示有助于肝脏EAML的诊断和鉴别诊断。 | 王昭华 吴东 侯君 张立涛 孔庆奎 | 2012 | 中华放射学杂志2012，46，9： | 13 |
| 5 | 肝脏血管平滑肌脂肪瘤的CT、MRI分型诊断价值及其病理基础显示文摘目的:探讨肝脏血管平滑肌脂肪瘤的CT、MRI分型诊断价值及其病理基础。方法:收集经临床和病理资料证实的肝脏血管平滑肌脂肪瘤21例,分析其CT、MRI征象,探讨CT、MRI对各型的分型诊断价值及其病理基础。结果:21例均行CT扫描,其中12例行MR检查。血管瘤型4例,病理上以粗大扭曲的异常血管或血管瘤为主,CT、MR增强扫描异常血管或血管瘤动脉期呈明显强化,门脉期强化程度仍高于同期肝实质。肌瘤型3例,病理上以平滑肌成分为主,脂肪成分很少(<10%)。CT平扫为较均匀低密度,MRIT1WI呈低信号,T2WI呈稍高信号;CT、MRI增强扫描动脉期呈明显强化,门脉期、延迟期呈持续强化。脂肪瘤型5例,病理上以脂肪成分为主(≥70%),CT、MRI显示脂肪密度或信号。混合型9例,CT平扫为含有脂肪的混杂密度,MRIT1WI病灶主体呈不均匀低信号,脂肪成分呈高信号,T2WI呈混杂高信号,CT、MRI增强扫描其内软组织成分动脉期呈明显强化,门脉期仍有强化。病理上血管、平滑肌、脂肪3种成分比例接近(其中脂肪成分占10%~70%)。免疫组化:上述21例均显示HMB45(+)、SMA(+)。结论:CT、MRI能较好地反映肝脏血管平滑肌脂肪瘤的分型和各型的病理特征,具有一定的诊断特异性。 | 林光武 嵇鸣 | 2010 | 中国医学计算机成像杂志2010，16，4： | 13 |
| 6 | Hepatic angiomyolipoma: Dynamic computed tomography features and clinical correlation显示文摘AIM: To study the dynamic computed tomography (CT) features of hepatic angiomyolipoma (AML) in patients with or without tuberous sclerosis complex (TSC).METHODS: The clinical information, CT fi ndings and histopathological results of hepatic AML were analyzed retrospectively in 10 patients.RESULTS: Hepatic AML was prone to occur in female patients (7/10), and most of the patients (8/10) had no specific symptoms. All tumors presented as well-def ined, unenveloped nodules in the liver. Six patients with sporadic hepatic AML had a solitary hepatic nodule with a definite fat component. Non-fat components of the hepatic lesions were enhanced earlier and persistently. Prominent central vessels were noted in the portal venous phase in three patients. In four patients with hepatic AML and TSC, most of the nodules were within the peripheral liver. Seven fat-deficient nodules were found with earlier contrast enhancement and rapid contrast material washout in two patients. Lymphangioleiomyomatosis was found in one patient.CONCLUSION: Imaging features of hepatic AML are characteristic. Correct diagnosis preoperatively can be made in combination with clinical features. | Bin Yang Wen-Hui Chen Qiao-Yun Li Jing-Jing Xiang Ru-Jun Xu | 2009 | World Journal of Gastroenterology2009，15，27： | 10 |
| 7 | Clinical features of hepatic angiomyolipoma显示文摘BACKGROUND:Hepatic angiomyolipoma(HAML)is a rare hepatic mesenchymal tumor.This study was designed to explore its clinical features. METHODS:Clinical data from 26 patients who had been pathologically confirmed with HAML and had received surgical resection at our hospital were analyzed retrospectively. RESULTS:HAML was seen more frequently in females(18/26) in this series,and most of the patients presented no significant symptoms except for one who had a spontaneous rupture hemorrhage.Serum alpha-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA) were negative in all patients.Imaging presentations were diverse.Pre-operative diagnosis was made in only 3 patients Pathological study showed that the tumor was composed of adipose tissue,smooth muscle and blood vessels in different proportions.One patient showed hepatic vessel invasion HMB-45 immunohistochemical staining was positive in all tumors.All patients underwent surgical resection without significant complications.Except for one patient who died 14 months after operation because of recurrent disease,no tumor recurrence was observed in the remaining 25 patients during a 2-3 years follow-up. CONCLUSIONS:Pre-operative diagnosis of HAML is difficult.There are potential risks of spontaneous rupture and malignant transformation.Surgical resection is the treatment of choice for HAML. | Zhou, Yan-Ming Li, Bin Xu, Feng Wang, Bin Li, Dian-Qi Zhang, Xiao-Feng Liu, Peng Yang, Jia-Mei | 2008 | Hepatobiliary & Pancreatic Diseases International2008，7，3： | 9 |
| 8 | A case of hepatic angiomyolipoma difficult to distinguish from hepatocellular carcinoma显示文摘We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma. | Masahiro Takahara Yasuhiro Miyake Kazuyuki Matsumoto Daisuke Kawai Eisuke Kaji Tatsuya Toyokawa Morihito Nakatsu Masaharu Ando Mamoru Hirohata | 2009 | World Journal of Gastroenterology2009，15，23： | 8 |
| 9 | 肝脏乏脂肪型血管平滑肌脂肪瘤的CT诊断显示文摘目的探讨肝脏乏脂肪型血管平滑肌脂肪瘤(mHAML)的CT诊断及其鉴别诊断,提高对肝脏不典型占位病变的认识。方法选择5例经手术或穿刺活检证实的mHAML,均行CT平扫及三期动态增强扫描,分析薄层轴位及最大密度投影(MIP)重组图像CT表现。结果 5例均为肝内单发病灶,边界清晰,CT平扫呈均匀稍低密度,未测得脂肪密度。5例CT增强动脉期均呈全瘤欠均匀明显强化,其中3例门脉期及延迟期持续强化高于周围肝实质密度,时间-密度曲线呈'速升缓降'改变;2例门脉期强化密度迅速减低,呈'速升速降'表现。5例病灶动脉期薄层及MIP重组图像显示中央均可见迂曲粗大点、条状血管影,其中1例病灶周边见动脉期提早显示引流肝静脉影。病理组织学示5例病灶内主要含血管和平滑肌成分,脂肪含量极少(<10%)。结论 mHAML CT动态增强扫描强化特征与其他富血供病变类似,导致鉴别诊断困难。多排螺旋CT(MDCT)薄层及MIP重组技术对鉴别诊断有重要价值。无肝炎病史、肝硬化背景,AFP正常,肝内病灶无包膜,动脉期其中央出现迂曲粗大点、条状血管影伴或不伴病灶周边引流肝静脉早期显影者,提示mHAML可能。 | 王伟 楼俭茹 栾丽 杨昕 陈嘉麟 | 2013 | 新疆医科大学学报2013，36，10： | 7 |
| 10 | 肝脏血管平滑肌脂肪瘤临床病理分析显示文摘目的探讨肝脏血管平滑肌脂肪瘤(HAML)的临床病理特征。方法结合文献对1例HAML的临床资料、免疫组化、超微结构和随访结果进行分析。结果HAML女性好发,成人多见,常无症状,体检发现:影像学因肿瘤成分构成比和分布不同而异;肿瘤由厚壁畸形血管、成熟脂肪和多形肌样细胞构成,并常见有单核、多核和巨核细胞呈散在巢团状集聚和灶性髓外造血灶;上皮样肌样细胞HMB45、CD117阳性及超微结构见不同成熟时期黑色素小体;治疗以手术为主。结论HAML主要由血管、脂肪、平滑肌3种成分组成,其中变化最大的是肌样细胞,肌样细胞HMB45标记及电镜检查不同发育时期黑色素小体是诊断HAML的关键。HAML多为良性,首选手术,但有恶性HAML的报道。 | 王卓才 黄小让 马建青 张伟 邝智智 周爱民 | 2007 | 肿瘤基础与临床2007，20，1： | 6 |
| 11 | 穿刺活检在诊断肝血管平滑肌脂肪瘤中的价值显示文摘目的总结肝血管平滑肌脂肪瘤穿刺活检标本的组织病理学形态、免疫组化及诊断和鉴别诊断要点,探讨提高诊断准确率、降低误诊率的方法。方法对9例肝血管平滑肌脂肪瘤穿刺活检病例进行临床病理与免疫组化观察。结果 9例肝血管平滑肌脂肪瘤中女性8例,男性1例,年龄25~62岁,中位年龄43岁;肿瘤直径2~10 cm;5例为肌瘤型,3例为混合型,1例为脂肪瘤型;其中8例HMB45(+),1例HMB45(-)但melan A(+)。仅1例术前影像学诊断考虑为肝血管平滑肌脂肪瘤,而未行免疫组化检测、仅依靠光镜观察,有4例得出正确的病理诊断。结论肝血管平滑肌脂肪瘤的组织形态变化多样,穿刺活检标本更易误诊或漏诊,确切的病理诊断还需借助于免疫组化,尤其是HMB45和melan A对鉴别诊断有重要意义。 | 刘毅强 孙宇 李忠武 薛卫成 陆爱平 李吉友 | 2011 | 诊断病理学杂志2011，18，1： | 5 |
| 12 | 磁共振成像和计算机X线断层扫描肝对血管平滑肌脂肪瘤的诊断价值显示文摘为了探讨磁共振成像(MRI)和计算机X线断层扫描(CT)肝对血管平滑肌脂肪瘤的诊断价值,本研究选择了我院收治的肝脏血管平滑肌脂肪瘤患者43例作为研究对象,分别采用MRI和CT对患者进行检查,比较CT和MRI单独诊断及CT+MRI联合诊断时的检出率和误诊率。43例肝脏血管平滑肌脂肪瘤患者中女性占74.4%,平均年龄为(44.3±9.8)岁。65.1%的患者无明显临床症状,有症状的患者主要为腹痛。患者的肿瘤直径为(4.76±2.3)cm,肿瘤部位主要为肝右叶(67.4%)。经病理结果证实,血管瘤型、肌瘤型、脂肪瘤型和混合型依次为5例、7例、11例和20例。CT和MRI的联合诊断检出率(72.09%)高于CT(48.84%)或MRI(46.51%)单独诊断,然而差异不显著(p<0.05)。误诊类型主要包括肝细胞癌、腺瘤、血管瘤和肝脏局灶性结节增生。CT+MRI联合诊断时的误诊率(23.26%)显著低于CT(48.84%)和MRI(46.51%)单独诊断。CT和MRI联合诊断有助于降低误诊率,然而,仍需要做进一步的病理检查。 | 牛亚琦 杨莉 | 2019 | 基因组学与应用生物学2019，38，9： | 5 |
| 13 | 肝脏血管周上皮细胞肿瘤与肝细胞肝癌及肝血管瘤的超声特征分析显示文摘目的:提高彩色多普勒超声对于肝脏血管周上皮细胞肿瘤的诊断水平及与肝细胞肝癌和血管瘤的鉴别。方法:搜集肝脏血管周上皮细胞肿瘤、肝细胞肝癌、肝血管瘤患者,回顾性分析这些患者的一般情况、超声及超声造影特征,并总结分析。结果:在一般资料中,三组在性别、年龄、症状、AFP水平、HBsAg指标中有统计学差异,P<0.05,在常规超声中,三组在大小、边界、高回声边缘、主要回声、内部低回声、点状或短线状强回声、回声分布、后方回声、血流分布、病灶数量、肝脏背景指标中有统计学差异,P<0.05,在超声造影中,三组在动脉期增强强度无统计学差异,大部分都表现为高增强,P>0.05,但是在增强方式上是有区别,三组在开始增强时间、达峰时间、开始消退时间有统计学差异,P<0.05。结论:肝脏血管周上皮细胞肿瘤在临床特征、超声及超声造影有一定的特点,在与肝细胞肝癌及肝血管瘤鉴别时,常规超声联合超声造影能提高该病的诊断准确率。 | 韩伟 候雪琴 宋涛 高军喜 | 2021 | 中国临床医学影像杂志2021，32，5： | 5 |
| 14 | 肝上皮样血管平滑肌脂肪瘤临床病理诊断显示文摘上皮样血管平滑肌脂肪瘤(epithelioid angiomyolipoma,EAML)是血管平滑肌脂肪瘤(angiomyolipoma,AML)的罕见亚型,主要发生于肾脏,但可偶见于肾外,如肝、肺、淋巴结、腹膜后等部位,我们近期遇到3例肝EAML,报告如下。 | 石麒麟 胡赟 夏慧 张晓岚 | 2010 | 中华普通外科杂志2010，25，6： | 5 |
| 15 | Diagnostic analysis of hepatic angiomyolipoma显示文摘BACKGROUND: Hepatic angiomyolipoma (HAML) is a rare tumor containing a variable amount of fat, vessels and smooth muscle. We report the image findings on ultra- sonography and computed tomography ( CT) of huge HAML. METHOD; The clinical, imaging and pathological data of a case of HAML were retrospectively collected and ana- lyzed. RESULTS; A huge heterogeneous hyperecho mass with anecho and hypoecho areas inside was found in the left he- patic lobe on ultrasonography. Color Doppler showed blood flow and arterial spectrum in it. CT scan showed a huge heterogeneous solid mass in the left lobe of the liver, with a low density and hypervascular area in arterial phase. The serum tumor marks were all negative. Ultrasound- guided biopsy was taken twice before resection and both showed necrosis tissue and reaction of inflammatory cells. Postoperative pathological results showed that the tumor was composed of epithelioid smooth muscle cells, thick- walled blood vessels and a few adipose cells with necrosis. The immunohistochemistry results showed appea-rance of typical HAML, with HMB-45 positive and alpha fetopro- tein (AFP) negative. CONCLUSIONS: Preoperative diagnosis of HAML relies on combination of CT, MRI and ultrasonography. Our case of HAML showed heterogeneous hyperecho image on ultra- sonography. Ultrasound-guided biopsy combined with morphological manifestation and specimen examination for HMB-45 may be helpful in the diagnosis of HAML. | Tian-An Jiang, Qi-Yu Zhao, Miao-Yan Chen, Li-Jun Wang and Jian-Yang Ao Hangzhou, China Department of Ultrasonography, First Affiliated Hos- pital , Distance Education Center and Department of Pathology, First Affiliated Hospital , Zhejiang University School of Medicine, Hangzhou 310003, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，1： | 4 |
| 16 | 超声造影联合增强CT诊断不典型肝血管平滑肌脂肪瘤的临床价值显示文摘选取2011年6月~2017年6月于我院就诊的经病理学检查明确确诊为肝血管平滑肌脂肪瘤(HAML)的43例患者,通过对纳入患者的49个HAML病灶的超声造影(CEUS)及增强CT(CECT)的影像学表现及术前诊断结果进行分析,探讨CEUS联合CECT在诊断不典型HAML中的临床价值。结果显示,HAML在女性中的发病率显著高于男性(P<0.001),且HAML多为单发病灶(P<0.001)。术前经CECT准确诊断HAML者有34.69%,经CEUS准确诊断HAML者有57.14%,二者联合准确诊断HAML者有77.55%,联合诊断的准确性显著高于单独应用CECT或CEUS(P<0.05)。HAML在CECT和CEUS上的表现具有一定的特征性,二者联合应用可以提高HAML诊断正确率。 | 李士英 陈金叶 | 2020 | 影像科学与光化学2020，38，3： | 4 |
| 17 | 肝脏血管平滑肌脂肪瘤的超声图像特征分析显示文摘目的分析肝脏血管平滑肌脂肪瘤的超声图像特点及超声诊断价值。方法回顾性分析15例经手术及病理证实的肝脏血管平滑肌脂肪瘤的超声图像特点,总结病变的部位、数目、大小、形态、边界、内部回声情况及血流特征。结果 15例患者均为单发,其中13例位于右肝,2例位于左肝;肿瘤直径范围为1.5~18cm,平均直径为8.2cm。超声检查3例为均匀强回声,1例为均匀低回声,11例为混合回声;12例形态规则,3例形态不规则;11例边界清晰,4例边界不清;13例可探及点线状血流信号;诊断正确率为7%,提示肝脏占位诊断占60%,误诊率占33%。结论典型肝脏血管平滑肌脂肪瘤超声检查有特征性表现,超声可作为其术前诊断的首选影像学方法。 | 聂芸 王蕾 李利琼 | 2013 | 西部医学2013，25，4： | 2 |
| 18 | 肝血管平滑肌脂肪瘤的病理诊断显示文摘目的:探讨肝血管平滑肌脂肪瘤(HAML)的免疫组织化学特征及超微结构特点。方法:对5例HMAL进行免疫组化及超微结构观察,并结合文献分析。结果:5例HAML中免疫组化显示:瘤细胞呈HMB45(5/5)、SMA(5/5)、S-100(3/5)阳性、CD34、CKp、Hepatocyte、CD10、Inhibinα阴性。超微结构下瘤细胞形态多样,大小不一,短梭形或圆形或多形性,细胞核大小一致,多呈圆形或短梭形,常染色质丰富,异染色质呈质块状;部分细胞核切迹明显;核仁大小不一,胞浆内线粒体丰富,部分细胞浆内可见多少不等的密体;少部分细胞可见少量脂滴;多数胞浆内可见100~200nm左右的致密颗粒;细胞间可见基底膜样物质围绕细胞周围,仅个别细胞可见桥粒样连接。结论:HAML具有特殊的免疫组化特征及超微结构特点;HMB45和SMA的双阳性表达及超微结构下密体和致密颗粒的并存对HAML的诊断具有重要的意义。 | 陈旭东 何松 张婷 陈亚丽 | 2008 | 南京医科大学学报(自然科学版)2008，28，10： | 2 |
| 19 | 肝上皮样血管平滑肌脂肪瘤Gd-EOB-DTPA增强和DWI表现一例显示文摘患者女,23岁。右上腹隐痛不适5天入院。体检:腹平软,肝肋下3指,肝区叩击痛(-),全腹无压痛。既往无肝炎、血吸虫等传染病史,无口服避孕药史。实验室检查:AFP1.92 ng/ml,CEA 1.66 ng/ml。MRI见肿瘤位于肝右叶前下段(Ⅴ段),类圆形,大小约58 mm×56 mm,T2WI呈高信号,信号欠均匀(图1),T1WI呈均匀低信号(图2), | 孙骏 吴晶涛 陈文新 王守安 | 2015 | 临床放射学杂志2015，34，6： | 2 |
| 20 | 磁共振成像和计算机X线断层扫描对肝脏血管平滑肌脂肪瘤的诊断价值显示文摘【目的】探讨磁共振成像(MRI)和计算机X线断层扫描(CT)对肝脏血管平滑肌脂肪瘤的诊断价值.【方法】回顾性分析2013年1月至2017年12月本院收治的43例肝脏血管平滑肌脂肪瘤患者的临床资料,所有患者均经手术及病理检测确诊.分别采用MRI和CT对患者进行检查,比较CT和MRI单独诊断及CT+MRI联合诊断时的检出率和误诊率.【结果】43例患者中女性占74.4%(32/43),肿瘤部位主要为肝右叶(67.4%,29/43),65.1%(28/43)患者无临床症状,有症状的患者主要为腹痛,肿瘤直径一般在10 cm以下,平均直径(4.76±2.3)cm.经病理结果显示血管瘤型、肌瘤型、脂肪瘤型和混合型分别为5例、7例、11例和20例.CT、MRI对肝脏血管平滑肌脂肪瘤的检出率有差异,但无统计学意义(χ^2=0.989,P=0.616>0.05);CT联合MRI诊断检出率为72.09%高于CT或MRI单独诊断,但无统计学意义(χ^2=1.834,P=0.276>0.05;χ^2=0.131,P=0.822>0.05).误诊类型主要包括肝细胞癌、腺瘤、血管瘤和肝脏局灶性结节增生.CT、MRI对肝脏血管平滑肌脂肪瘤的误诊情况有差异,但无统计学意义(χ^2=0.381,P=0.984>0.05);CT+MRI联合诊断时误诊率显著低于CT(χ^2=6.317,P=0.025<0.05)、MRI(χ^2=5.927,P=0.034<0.05)单独诊断.【结论】肝脏血管平滑肌脂肪瘤的诊断需要结合多种检查方式进行确诊,CT和MRI联合诊断虽可降低误诊率,但仍需要做进一步的病理切片检查. | 闫海波 张志恒 | 2019 | 医学临床研究2019，36，10： | 2 |
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