肝细胞腺瘤的诊治

摘要

Objective To study the diagnosis and treatment of hepatocellular adenoma(HCA).Methods The preoperative imaging findings,pathologic specimens and surgical treatment of 18 patients with HCA who were admitted in our hospital from January 1990 to April 2007 were retrospectively analyzed.Results Most patients were male(male-to-female:11/7)and only 1 female patient had oral contraceptive history.Six patients presented with pain in the right upper quadrant.Contrast-enhanced CT and contrast-enhanced MRI both displayed that most lesions were characterized by homogeneous enhancement on arterial phase,except the lesions affected by irregular hemorrhage or fatty degeneration,and by washout on portal venous phase and delayed phase.All patients received resection.Hemorrhage in the lession was found in 10 patients and precancerous lesion in 2after operation.All patients were alive and well with no recurrence till December 2007.Conclusion The enhanced CT or MRI scanning for HCA has special features.Complete resection is the first choice for HCA.%目的 探讨肝细胞腺瘤(hepatocellular adenoma,HCA)的诊断和治疗经验.方法 回顾性分析我院1990年1月至2007年4月收治的18例HCA患者的临床、病理和影像学资料.结果 男女比例为11:7,1例女性患者有口服避孕药史.33%(6/18)的患者表现为右上腹不适或右上腹痛.CT和MRI增强扫描显示不规则出血或脂肪变性,多数病灶动脉期均匀强化,门脉期及延迟期造影剂退出.全部患者均经手术完整切除肿瘤.10例病灶内有出血表现,2例病理检查发现癌前病变.术后随访至2007年12月均存活无复发.结论 国内HCA多为自发性,且与口服避孕药无关,增强扫描有一定特异表现.手术完整切除肿瘤是首选的治疗方法,且预后良好.