39例肝细胞腺瘤影像学特点分析*

doi:10.3969/j.issn.1672-5069.2026.04.033

摘要/Abstract

摘要： 目的回顾总结肝细胞腺瘤(HCA)影像学特征,为临床诊治提供经验。方法 2020年5月～2024年3月我院收治的39例HCA患者,接受腹部CT和MR检查,取组织行免疫组化和基因表型检测。结果本组包括炎症型HCA(I-HCA)18例,β-链蛋白突变激活型(B-HCA)10例,肝细胞核因子1α突变失活型(H-HCA)6例和未分类型(U-HCA)5例;I-HCA病灶CT增强扫描延迟期低强化占55.6%,显著高于H-HCA的10.0%(P<0.05)或H-HCA的0.0%(P<0.05)或U-HCA的0.0%(P<0.05);B-HCA病灶包膜下增强血管影占比为100.0%(P<0.05),显著高于I-HCA的38.9%(P<0.05)或H-HCA的10.0%(P<0.05)或U-HCA的20.0%(P<0.05);I-HCA病灶MR T1WI序列高信号占比为72.2%,显著高于H-HCA的10.0%(P<0.05)或B-HCA的16.7%(P<0.05)或U-HCA的0.0%(P<0.05);H-HCA病灶T2WI序列以低信号为主,表现为轻度增强,强化逐步减退,均与其他分型存在显著性差异(P<0.05)。结论 HCA以I-HCA多见,不同分子分型HCA病灶CT和MRI征象略有差异,需在今后的研究中进一步总结完善。

关键词: 肝细胞腺瘤, CT扫描, 磁共振成像, 分子分型

Abstract: Objective The aim of this study was to summarize imaging features of hepatocellular adenoma (HCA). Methods The clinical materials of 39 patients with HCA encountered in our hospital between May 2020 and March 2024 were reviewed. All patients underwent CT and MR scan. Histo-pathological typing was performed by immunohistochemistry and genotype sequencing. Results Of 39 patients with HCA in our series, inflammatory HCA (I-HCA), β-catenin-activated HCA (B-HCA), hepatocyte nuclear factor 1α-inactivated HCA (H-HCA) and unclassifled HCA (U-HCA) were found in 18 cases, 10 cases, 6 cases and 5 cases, respectively; percentage of low enhancement at delayed phase in I-HCA lesions was 55.6%, much higher than 10.0%(P<0.05) in H-HCA or 0.0%(P<0.05)in H-HCA or 0.0%(P<0.05)in U-HCA lesions; percentage of subcapsular enhancement in B-HCA lesions was 100.0%(P<0.05), much higher than 38.9%(P<0.05) in I-HCA or 10.0%(P<0.05)in H-HCA or 20.0%(P<0.05)in U-HCA; percentage of high signal at MR T1WI sequence in I-HCA was 72.2%, much higher than 10.0%(P<0.05) in H-HCA or 16.7%(P<0.05) in B-HCA or 0.0%(P<0.05)in U-HCA lesions; low signal intensity at T2WI sequence in H-HCA was more common, with a slight enhancement, gradually decreased, significantly different from other HCA types(P<0.05). Conclusion I-HCA is more common clinically, with a slight different imaging feature in different HCA types, which needs further summarization.

Key words: Hepatocellular adenoma, CT scan, Magnetic resonance imaging, Molecular typing

左仁智, 王凯旋, 葛尚. 39例肝细胞腺瘤影像学特点分析^*[J]. 实用肝脏病杂志, 2026, 29(4): 609-612.

Zuo Renzhi, Wang Kaixuan, Ge Shang. Imaging feature of hepatocellular adenoma: An analysis of 39 cases[J]. Journal of Practical Hepatology, 2026, 29(4): 609-612.

参考文献

[1] Poetter-Lang S, Ba-Ssalamah A, Bastati N, et al. Hepatocellular adenoma update: diagnosis, molecular classification, and clinical course. Br J Radiol, 2024, 97(1163):1740-1754.
[2] Hashimoto S, Hasan MDN, Arif M, et al. Aberrantly expressed tRNA-val fragments can distinguish canine hepatocellular carcinoma from canine hepatocellular adenoma. Genes (Basel), 2024, 15(8):1024.
[3] Declaux G, Denis de Senneville B, Trillaud H, et al. Assessment of a multivariable model using MRI-radiomics, age and sex for the classification of hepatocellular adenoma subtypes. Res Diagn Interv Imaging, 2024, 10:100046.
[4] Cao JJ, Shen L, Yoon L, et al. Differentiation of hepatocellular adenoma subtypes and focal nodular hyperplasia on gadoxetate disodium-enhanced MRI: An updated diagnostic algorithm. AJR, 2024, 223(4):e2431628.
[5] Alareer HSN, Jasim Taher H, Dinar Abdullah A. Dynamic contrast enhanced-MRI and apparentdiffusion coefficient quantitation for differentiate hepatocellular carcinoma from hepatocellular adenoma. Asian Pac J Cancer Prev, 2024, 25(3):931-937.
[6] Verde F, Ponsiglione A. Role of perfusion features in contrast-enhanced ultrasound differential diagnosis of hepatocellular adenoma and carcinoma: Far beyond the gray-scale ultrasound. J Clin Ultrasound, 2022, 50(2):222-223.
[7] Liu YH, Fan ZH, Yin SS, et al. Diagnostic value of color parametric imaging and contrast-enhanced ultrasound in the differentiation of hepatocellular adenoma and well-differentiated hepatocellular carcinoma. J Clin Ultrasound, 2022, 50(2):216-221.
[8] Park HJ, Byun JH, Kang JH, et al. Value of discrepancy of the central scar-like structure between dynamic CT and gadoxetate disodium-enhanced MRI in differentiation of focal nodular hyperplasia and hepatocellular adenoma. Eur J Radiol, 2021, 139:109730.
[9] Nie P, Wang N, Pang J, et al. CT-based radiomics nomogram: A potential tool for differentiating hepatocellular adenoma from hepatocellular carcinoma in the noncirrhotic liver. Acad Radiol, 2021, 28(6):799-807.
[10] Cannella R, Borhani AA, Minervini MI, et al. Evaluation of texture analysis for the differential diagnosis of focal nodular hyperplasia from hepatocellular adenoma on contrast-enhanced CT images. Abdom Radiol (NY), 2019, 44(4):1323-1330.
[11] Abdullah AD, Amanpour-Gharaei B, Nassiri Toosi M, et al. Comparing texture analysis of apparent diffusion coefficient MRI in hepatocellular adenoma and hepatocellular carcinoma. Cureus, 2024, 16(1):e51443.
[12] 王鹏雁, 邵汇琳, 班新超, 等. 基于免疫组化的肝细胞腺瘤分型及临床病理学分析. 中华肝胆外科杂志, 2019, 25(7):509-512.
[13] Huang Z, Li Y, Chen W, et al. Insulin-like growth factor-1 deficiency caused by hepatocellular adenoma leads to growth arrest, primary amenorrhea and metabolic syndrome: a case report and 4 years follow up. BMC Endocr Disord, 2024, 24(1):188.
[14] Bu Y, Huang R, Gao J, et al. Whole-exome sequencing-based mutational profiling of hepatocellular adenoma malignant transformation to hepatocellular carcinoma. Clin Exp Pharmacol Physiol, 2024, 51(7):e13901.
[15] Huang J, Xu D, Li A. Laparoscopic hepatectomy for hepatocellular adenoma using the hepatic vein as anatomic markers: How I do it (with video). Asian J Surg, 2024, 47(12):5143-5146.
[16] 潘豪, 陈小凤, 韩晶, 等. 肝细胞核因子1α失活型肝细胞腺瘤的MRI特征分析. 中华肝脏病杂志, 2023, 31(11):1192-1197.
[17] Iwabuchi S, Takahashi K,Kawaguchi K, et al. Phospholipase a2 group IIA is associated with inflammatory hepatocellular adenoma. Cancers (Basel), 2023, 16(1):159.
[18] Renzulli M, Pettinari I, Vasuri F, et al. Liver collision lesion: inflammatory hepatocellular adenoma within focal nodular hyperplasia. Gastroenterol Rep (Oxf), 2020, 9(4):374-376.
[19] Balabaud C, Laurent C, Le Bail B, et al. Unexpected discovery of small HNF1α-inactivated hepatocellular adenoma in pathological specimens from patients resected for liver tumours. Liver Int, 2018, 38(7):1273-1279.
[20] Haddouche A, Bellanne-Chantelot C, Rod A, et al. Liver adenomatosis in patients with hepatocyte nuclear factor-1 alpha maturity onset diabetes of the young (HNF1A-MODY): Clinical, radiological and pathological characteristics in a French series. J Diabetes, 2020, 12(1):48-57.

39例肝细胞腺瘤影像学特点分析^*

Imaging feature of hepatocellular adenoma: An analysis of 39 cases

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