肝脏上皮样血管内皮瘤的CT和MRI表现

发布时间：2018-05-12 03:36

本文选题：肝脏 + 上皮样血管内皮瘤　；参考：《临床放射学杂志》2015年03期

【摘要】：目的总结肝脏上皮样血管内皮瘤(HEHE)的CT和MRI表现。方法搜集经手术或穿刺活检后病理证实的HEHE 11例,所有的病例均行CT检查,其中5例行CT平扫及双期增强扫描(动脉期+门静脉期),其他6例行CT平扫及三期增强扫描(动脉期+门静脉期+延迟期)。11例中有5例加做MRI平扫及动态增强扫描。回顾性分析病变的生长方式、分布特点、密度(信号)特点、强化方式及邻近组织情况。结果 11例均表现为肝内多发病灶,大部分病灶位于肝包膜下,根据生长方式分为三型:结节型(5例),匍匐生长型(1例)和混合型(5例)。CT平扫,病灶均呈低密度,直径2 cm的病灶内见类圆形更低密度。MRI平扫:病灶呈T1WI低信号、T2WI高信号,直径2 cm的病灶信号不均匀(T1WI内见更低信号,T2WI内见更高信号)。其他影像学征象包括"棒棒糖征"(6例)、包膜退缩征(6例)。增强扫描:病灶直径1 cm的表现为轻度较均匀强化;病灶直径为1~2 cm主要表现为轻度较均匀强化;病灶直径2 cm的多为不均匀渐进性强化。结论 HEHE的CT和MRI表现具有一定的特征性,其强化方式与病灶的大小相关。
[Abstract]:Objective to summarize the CT and MRI findings of hepatic epithelioid hemangioendothelioma (HEHEH). Methods 11 cases of HEHE confirmed by pathology after operation or puncture biopsy were collected. All cases were examined by CT. Among them, 5 cases underwent plain CT scan and double phase enhanced CT scan (arterial phase portal venous phase), the other 6 cases underwent CT plain scan and three phase enhanced scan (arterial phase portal phase delayed phase. 11 cases), 5 cases were performed MRI plain scan and dynamic enhanced scan. The characteristics of growth, distribution, density (signal), enhancement and adjacent tissues were analyzed retrospectively. Results all the 11 cases showed multiple lesions in the liver, most of which were located under the hepatic capsule. According to the growth pattern, the lesions were divided into three types: nodular type (5 cases), creeping growth type (1 case) and mixed type (5 cases). The lesions with diameter of 2 cm showed round and lower density. MRI plain scan: the lesions showed T1WI low signal intensity and high signal intensity on T 2WI, and even lower signal intensity on T 1WI and higher signal intensity on T 2WI with a diameter of 2 cm. Other imaging signs included lollipop sign in 6 cases and capsule retreat sign in 6 cases. Contrast-enhanced scan showed that the diameter of the lesion was 1 cm, the diameter of the lesion was 1 ~ 2 cm, and the diameter of the lesion was 2 cm, most of the lesions were non-homogeneous and progressive enhancement. Conclusion CT and MRI findings of HEHE have some characteristics, and the enhancement mode is related to the size of the lesion.
【作者单位】：中山大学附属第一医院医学影像科;
【基金】：国家自然科学青年基金项目(编号:81000626) 广东省自然科学基金(编号:S2013010016004) 珠江科技新星专项(编号:2012J2200084) 中央高校基本科研业务费专项资金(编号:10ykpy11)
【分类号】：R735.7;R730.44;R445.2

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