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目的:探讨磁共振(MRI)检查对肝腺瘤诊断的意义。方法:回顾性分析15例经病理检查证实的肝腺瘤者MRI表现、表观扩散系数(ADC)值及术前或活检前的诊断,并与病理检查结果相对照。结果:15例肝腺瘤患者中14例患者术前诊断认为肝腺瘤可能性大,1例为肝腺瘤或肝脏局灶性结节增生(FNH)待鉴别。15例患者中除1例为多发肝腺瘤(9个病灶)、2例有2个病灶外,其余12例均为单发肝腺瘤,共有25个病灶。MRI检查结果显示:T1WI 22个病灶呈稍低信号,3个病灶呈稍高信号;T2WI 15个病灶呈高信号,10个病灶呈低信号;DWI 16个病灶呈稍高信号,9个病灶呈等信号。25个病灶中有24个病灶不同程度地含脂质成分,22个病灶见瘤内出血。9个病灶见假包膜强化。注射Gd-DTPA行增强扫描显示,所有病灶动脉期呈中度~明显强化,门脉期18个病灶呈稍低信号影,7个病灶呈稍高信号,延迟扫描18个病灶呈低信号影,7个病灶呈等信号;15例患者测量ADC值,同一患者病灶ADC值>肝实质ADC值。结论:MRI检查及ADC值的测量可以对肝腺瘤无创性诊断提供更准确的依据。
Objective: To investigate the significance of magnetic resonance imaging (MRI) in the diagnosis of hepatic adenoma. Methods: The MRI findings, apparent diffusion coefficient (ADC) values and preoperative or biopsy findings of 15 hepatic adenomas confirmed by pathology were analyzed retrospectively. The results were compared with the results of pathological examination. Results: The preoperative diagnosis of 14 patients with hepatic adenoma showed that the possibility of hepatoma was high. One case was hepatic adenoma or focal nodular hyperplasia of liver (FNH). Of the 15 patients, 1 had multiple hepatic adenomas (9 lesions), 2 had 2 lesions, and the remaining 12 had single hepatic adenomas with a total of 25 lesions. The results of MRI showed that there were 22 lesions in T1WI and slightly increased in 3 lesions, 15 lesions in T2WI showed high signal, 10 lesions showed low signal, 16 lesions in DWI showed slightly higher signal and 9 lesions showed And other signals. Twenty-four of the 25 lesions contained lipid components to varying degrees, and 22 lesions showed intratumoral hemorrhage. 9 lesions see the envelope enhancement. Gd-DTPA line enhanced scan showed that all lesions were moderate to significant arterial phase enhancement, portal lesion 18 lesions showed a slightly lower signal, 7 lesions showed a slightly higher signal, delayed scan 18 lesions showed low signal, 7 lesions showed equal signal; 15 patients measured ADC value, ADC value of lesion in the same patient> ADC value of liver parenchyma. Conclusion: MRI and ADC measurement can provide a more accurate basis for noninvasive diagnosis of hepatic adenoma.