Objective To explore the manifestations of magnetic resonance imaging (MRI)and CT scanning in patients with liver angio-myolipoma (HAML). Methods The clinical characteristics and imaging findings of seven patients with HAML proved by pathological examina-tion were retrospectively analyzed. These clinical data including age,sex,symptoms,tumor biomarkers and liver background were retrospectively analyzed. The imaging findings including number,size,location,fatty content,enhancement pattern,arterial supply and intratumoral vessels were recorded and analyzed. Results All these seven patients were females. Their ages ranged from 28 to 53 years old with average age of 43. 8 years old. Five cases were diagnosed as epithelioid HAML,and other two cases were diagnosed as non - epithelioid HAML. Lesions in 4 cases presented as fatty content,manifesting as marked low signal intensity from - 43 HU to - 49 HU on CT scanning,or presenting as hook side effect inside the tumor on MRI scanning. Lesions in 6 patients enhanced in a fast - in and fast - out patterns,one in fast - in and slow - out patterns. Lesions in 5 patients showed enhanced arterial supply in tumors,and lesions in 4 cases showed reticular and tortuous intratumoral vessels. Conclusion The detection of intratumoral fatty content is favorable to the diagnosis of HAML. For lesions without fatty content,then the diagnosis would be made in combination of clinical history and bioptic examination.%目的 探讨肝血管平滑肌脂肪瘤(HAML)的影像学特征,提高对HAML的术前诊断水平.方法 回顾性收集并分析经手术病理证实的7例HAML患者的临床及影像学资料,分析患者临床特点,包括年龄、性别、发病症状、肿瘤标记物、肝背景情况;分析病灶在CT和/或磁共振成像(MRI)的基本影像表现,包括数量、大小、部位、脂肪成分、强化方式、供血动脉、肿瘤内血管.结果 7例HAML患者均为女性,年龄28～53岁,平均年龄43.8±8.2岁.7例中除1例发生于肝硬化基础上,其余均见于正常肝背景.5例为上皮样HAML,2例为非上皮样HAML.4例只行双期增强CT检查,1例只行MRI平扫及增强检查,2例同时行增强CT及MR检查.4例在CT或MRI可见脂肪成分,在CT上表现为明显低密度区,CT值约为(负43-负49HU);在MRI上表现为瘤内勾边效应.6例表现为"快进快出"强化方式,1例表现为动脉期高强化及延迟强化.5例可见增粗的肿瘤供血动脉,4例可见肿瘤内网状、扭曲走行的血管影.结论 CT或MRI发现肿瘤内脂肪成分有助于术前明确诊断HAML.对于无脂肪成分肿块,需结合临床病史及穿刺活检确诊.
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