婴儿型肝脏血管内皮细胞瘤的影像表现和随访变化

发布时间：2018-04-16 11:22

本文选题：肝肿瘤 + 血管内皮瘤　；参考：《中国医学影像学杂志》2017年09期

【摘要】：目的分析婴儿型肝脏血管内皮细胞瘤(IHE)的CT、MRI表现及其随访变化,为指导临床制订治疗方案提供依据。资料与方法回顾性分析21例IHE,包括首次就诊和随访的影像学表现。其中3例同时接受CT、MRI平扫及增强扫描,13例仅接受CT平扫及增强扫描,5例仅接受MRI平扫及增强扫描,所有患儿均接受超声检查。结果 CT平扫肿瘤表现为肝内多发或单发、边界清晰的低密度病灶;MRI平扫T1WI呈低信号、T2WI呈高信号。增强扫描单发型IHE动脉期呈显著边缘结节状、条索样或环形强化,延迟期扫描可见肿瘤由周边向中心递进强化的特征;较大病灶中央的坏死区可始终无强化,部分病灶内可见条索样钙化灶。多发结节型IHE大部分结节呈明显全瘤强化,少部分中等强化;增强扫描各期强化程度逐渐下降,延迟期多数病灶呈稍高密度或等密度。3例患者误诊为肝母细胞瘤行手术切除,术后超声随访均未见复发;其余给予普萘洛尔口服治疗后随访,大部分病灶不同程度缩小,部分病灶完全消失。结论 IHE表现为多发和单发病灶,IHE的特征性CT、MRI表现有助于提高诊断准确率。口服普萘洛尔治疗IHE,病灶可自行减小或消退。
[Abstract]:Objective to analyze the CT MRI findings of infantile hepatic hemangioendothelioma (IHEA) and their follow-up changes in order to provide evidence for clinical treatment.Materials and methods the imaging findings of 21 cases of IHEs, including first visit and follow-up, were retrospectively analyzed.Among them, 3 cases received plain CT scan and 13 cases enhanced MRI scan only received plain CT scan and 5 cases only received MRI plain scan and enhanced scan. All the children were examined by ultrasound.Results CT plain scan showed multiple or single lesions in the liver, and the low-density lesions with clear boundary were characterized by low signal intensity and high signal intensity on T _ 2WI.Contrast enhanced IHE showed marked marginal nodular, stripe or ring enhancement in arterial phase, progressive enhancement from periphery to center in delayed phase, and no enhancement in the necrotic area in the center of larger lesion.In some lesions, stripe calcification can be seen.Most of the nodules of multiple nodular type IHE showed enhancement of the whole tumor, a few of them showed moderate enhancement, the enhancement degree of each phase of enhanced scan gradually decreased, and most of the lesions in the delayed phase were slightly high density or equal density. 3 cases were misdiagnosed as hepatoblastoma.No recurrence was found after ultrasound follow-up, and most of the lesions were reduced and some of the lesions disappeared completely after oral propranolol treatment.Conclusion IHE features with multiple or single lesions are helpful to improve the diagnostic accuracy.Oral propranolol treatment of IHE, the focus can be reduced or subsided.
【作者单位】：中国医科大学附属盛京医院放射科;沈阳军区总医院耳鼻喉科;
【分类号】：R445.2;R730.44;R735.7

【相似文献】