【摘要】 目的 探讨肝脏血管平滑肌脂肪瘤（hepatic angiomyolipoma，HAML）的多层螺旋CT影像学表现特征及其与病理学基础的相关性，以进一步提高CT诊断的准确性。 方法 收集2008年11月-2010年12月经手术病理证实的16例HAML患者。所有患者均行螺旋CT平扫及动脉期、门脉期增强检查，重点观察HAML的分型及其相应CT表现及影像-病理的相关性。 结果 16例患者共20个病灶，19个为稍低密度病灶，其中11个病灶内可见明显的脂肪密度影；1个为稍高密度病灶。动脉期所有病灶均有不同程度的强化表现，15个病灶内可见到较明显条状及扭曲的血管影。门脉期15个病灶有持续强化。 结论 多层螺旋CT能准确反映HAML的分型及其病理特征，对临床表现不典型患者的诊断和鉴别诊断有较大诊断价值。【Abstract】 Objective To discuss the correlation between the features of multislice spiral CT results for hepatic angiomyolipoma (HAML) and their pathological basis, and to further improve the diagnostic accuracy through CT examination. Methods Sixteen HAML patients diagnosed pathologically between November 2008 and December 2010 in our hospital were enrolled in our study. All patients underwent multi-slice spiral CT scanning of pre-and post-contrast arterial phase, and portal venous phase. Focus was put on observation of HAML types and their corresponding manifestations, and the correlation between CT imaging and the pathologic basis. Results There were 20 lesions in the 16 patients. Among the 19 hypodense lesions, 11 were clearly seen with fat density shadow. One out of the 20 lesions showed as slightly hyperdense. On the arterial phase scanning, all lesions showed enhancement, and obvious vascular shadow could be seen in15 lesions. On the portal venous phase, 15 lesions continued to strengthen. Conclusions Multi-slice spiral CT can accurately reflect the classification of HAML and its pathological features. It has a great value in the diagnosis and differential diagnosis of patients without typical clinical manifestations.
Objective?To evaluate the value of various CT features in differentiating renal angiomyolipoma (RAML) with minimal fat and renal cell carcinoma (RCC). Methods?The Cochrane Library, PubMed, MEDLINE (OVID), EMBase, and the Chinese Periodical Wed (CNKI, CBM, VIP) were searched. They were searched from Jan 2001 to Nov 2008. Trials screening, quality assessment, and data extraction was conducted according to the inclusion criteria recommended by the Cochrane Collaboration. The SROC curve and meta-analyses were performed by Meta-disc 1.4. Results?Seven trials, involving 482 patients and 513 tumors, were included. The studies were highly homogonous. It was considered that 8 features including single or multiple lesions, scanning density, calcification, angle with cortex, levering-cortex-up sign, lesions pro-trusion, homogeneous enhancement, and prolonged enhancement, played certain roles in differentiating RAML with minimal fat and RCC. Among these features, interface with the cortex was the most important, and the features of homogeneous enhancement and prolonged enhancement were the second most important. Conclusion?Besides measuring lipoid tissue in the tumor, there are another 8 features which are valuable to the differentiation of RAML with minimal fat and RCC.