Abstract：
Objective: To investigate the MRI imaging features of hepatocyte nuclear factor 1α- inactivated hepatocellular adenoma (H-HCA). Methods: Clinical data and MRI images of 19 H-HCA cases who were pathologically confirmed at Zhongshan Hospital Affiliated to Fudan University between August 2014 and July 2020 were retrospectively analyzed. Among them, there were 15 females and 4 males, aged 16-47 (32± 7) years old. Tumor number, location, shape, size, boundary, MRI plain scan signal intensity, dynamic enhancement features of each phase, presence or absence of intratumoral fat content, pseudocapsule, and others were analyzed. The differences in apparent diffusion coefficient (ADC) values between the lesion and the surrounding normal liver parenchyma were compared for statistical significance. t-test was used for statistical analysis. Results: There were a total of 24 lesions in 19 cases. 14 cases had solitary lesions, and five cases had multiple lesions. 15 and nine lesions were located in the right and left lobes of the liver, respectively. 20 lesions were round or quasi-round, and four were irregular or lobulated. The tumor\'s maximal diameter was 0.6-8.6 (3.5 ± 2.4) cm. T(1)-weighted image (WI) showed hyperintense to iso-intense signals in 20 lesions and hypointense signals in four. T(2)WI showed iso-to-slightly high signal intensity in 16 lesions, with two hyperintense and six hypointense signals. Diffusion-weighted image (DWI) revealed hyperintense to iso-intense signals. Lesions mean ADC value was (1.289 ± 0.222)×10(-3) mm(2)/s, while the adjacent normal liver parenchyma\'s mean ADC value was (1.307 ± 0.236)×10(-3) mm(2)/s, with no statistically significant difference between the two (P > 0.05). During the arterial phase, 15 of the 18 lesions that underwent dynamic contrast-enhanced scanning with gadoxetate disodium (Gd-DTPA) were mildly to moderately enhanced and three were strongly enhanced. The portal and hepatic venous phases had no continuous enhancement, while the delayed phase showed a hypointense signal. During the arterial phase, two of the six lesions scanned by gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid ((Gd-EOB-DTPA) dynamic enhancement were mildly to moderately enhanced, while four were strongly enhanced. The portal and hepatic venous phases had no continuous enhancement, while the transition and hepatobiliary-specific phases showed hypointense signals. Intracellular steatosis occurred in 21 lesions, of which 19 were diffuse steatosis and 16 formed pseudocapsules in the delayed phase. Conclusion: H-HCA often occurs in young females as solitary lesions and has certain MRI features. T1WI anti-phase diffuse signal reduction and post-enhanced hypovascular withdrawal enhancement patterns can aid in accurately diagnosing the disease condition.
目的： 探讨肝细胞核因子1α失活型肝细胞腺瘤（H-HCA）的MRI影像特征。 方法： 回顾性分析复旦大学附属中山医院2014年8月至2020年7月经病理证实的19例H-HCA患者的临床资料及MRI图像，其中女性15例，男性4例，年龄16～47（32±7）岁；分析肿瘤数目、部位、形态、大小、边界，MRI平扫信号强度、动态增强各期强化特点，肿瘤内有无脂肪及其含量、假包膜等，比较病灶及其周围正常肝实质的表观扩散系数（ADC）值差异有无统计学意义。计量资料采用配对样本t检验。 结果： 19例患者共24枚病灶，14例单发，5例多发；位于肝右叶15枚、左叶9枚；20枚呈圆形及类圆形，4枚呈不规则或分叶状；肿瘤最大直径为0.6～8.6（3.5±2.4）cm。20枚病灶T(1)加权成像（WI）呈等及高信号，4枚呈低信号；16枚病灶T(2)WI呈等及稍高信号，2枚呈高信号，6枚呈低信号；弥散加权成像（DWI）均呈等及高信号；病灶的平均ADC值为（1.289±0.222）×10(-3) mm(2)/s，邻近正常肝实质平均ADC值为（1.307±0.236）×10(-3) mm(2)/s，两者差异无统计学意义(P>0.05)。行钆喷酸葡甲胺（Gd-DTPA）动态增强扫描的18枚病灶，动脉期呈轻中度强化15枚，高度强化3枚，门静脉期、肝静脉期无持续性强化，延迟期均呈低信号；行钆塞酸二钠（Gd-EOB-DTPA）动态增强扫描的6枚病灶，动脉期呈轻中度强化2枚，高度强化4枚，门静脉期、肝静脉期无持续性强化，移行期及肝胆特异期均呈低信号。21枚病灶发生细胞内脂肪变性，其中19枚弥漫性脂肪变性；16枚病灶延迟期形成假包膜。 结论： H-HCA好发于青年女性，常单发，具有一定特征性MRI特征；T(1)WI反相位弥漫性信号减低及增强后低血供退出型强化模式可有助于疾病的正确诊断。.
目的： 探讨肝细胞核因子1α失活型肝细胞腺瘤（H-HCA）的MRI影像特征。 方法： 回顾性分析复旦大学附属中山医院2014年8月至2020年7月经病理证实的19例H-HCA患者的临床资料及MRI图像，其中女性15例，男性4例，年龄16～47（32±7）岁；分析肿瘤数目、部位、形态、大小、边界，MRI平扫信号强度、动态增强各期强化特点，肿瘤内有无脂肪及其含量、假包膜等，比较病灶及其周围正常肝实质的表观扩散系数（ADC）值差异有无统计学意义。计量资料采用配对样本t检验。 结果： 19例患者共24枚病灶，14例单发，5例多发；位于肝右叶15枚、左叶9枚；20枚呈圆形及类圆形，4枚呈不规则或分叶状；肿瘤最大直径为0.6～8.6（3.5±2.4）cm。20枚病灶T(1)加权成像（WI）呈等及高信号，4枚呈低信号；16枚病灶T(2)WI呈等及稍高信号，2枚呈高信号，6枚呈低信号；弥散加权成像（DWI）均呈等及高信号；病灶的平均ADC值为（1.289±0.222）×10(-3) mm(2)/s，邻近正常肝实质平均ADC值为（1.307±0.236）×10(-3) mm(2)/s，两者差异无统计学意义(P>0.05)。行钆喷酸葡甲胺（Gd-DTPA）动态增强扫描的18枚病灶，动脉期呈轻中度强化15枚，高度强化3枚，门静脉期、肝静脉期无持续性强化，延迟期均呈低信号；行钆塞酸二钠（Gd-EOB-DTPA）动态增强扫描的6枚病灶，动脉期呈轻中度强化2枚，高度强化4枚，门静脉期、肝静脉期无持续性强化，移行期及肝胆特异期均呈低信号。21枚病灶发生细胞内脂肪变性，其中19枚弥漫性脂肪变性；16枚病灶延迟期形成假包膜。 结论： H-HCA好发于青年女性，常单发，具有一定特征性MRI特征；T(1)WI反相位弥漫性信号减低及增强后低血供退出型强化模式可有助于疾病的正确诊断。.
摘要：
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