儿童肝脏脉管性病变的影像诊断

发布时间：2018-08-25 15:02

【摘要】：目的:分析儿童肝脏脉管性病变的影像学特征,复习国际脉管性病变研究协会(ISSVA)脉管性病变分类及命名标准,明确影像诊断及正确命名在肝脏脉管性病变诊断中的重要性。方法:搜集本院2006年1月-2014年12月91例儿童肝脏脉管性病变患者的病例资料,其中3例经手术证实,48例经随访证实。91例中男46例,女45例,年龄15天-11岁,中位年龄3岁。将影像诊断(超声、CT、MRI)与术后病理结果以及随访资料进行对照分析。结果:91例中89例未按照ISSVA标准正确命名;CT和MRI显示肝脏脉管性病变表现为孤立性单发肿瘤57例,多发肿瘤21例,弥漫性肿瘤13例;病变的CT和MRI表现相似,均为动脉期明显强化,静脉期持续强化,表现为"快进慢出"的特点;91例中4例合并Kasabach-Merritt综合征。结论:肝脏脉管性病变亦需根据ISSVA标准进行规范命名和分类,影像检查是儿童肝脏脉管性病变的首选诊断方法。
[Abstract]:Objective: to analyze the imaging features of hepatic vascular lesions in children, review the classification and naming criteria of (ISSVA) vascular lesions of the International Association for the study of Vascular lesions, and clarify the importance of imaging diagnosis and proper naming in the diagnosis of hepatic vascular diseases. Methods: the data of 91 children with hepatic vascular diseases from January 2006 to December 2014 were collected. Among them, 48 cases were confirmed by operation. Among them, 46 cases were males and 45 cases were females, aged from 15 days to 11 years, with a median age of 3 years. Imaging diagnosis (CT MRI) was compared with postoperative pathological results and follow-up data. Results among 91 cases, 89 cases were not named correctly according to ISSVA standard. Ct and MRI showed that 57 cases of hepatic vascular lesions showed solitary tumors, 21 cases of multiple tumors and 13 cases of diffuse tumors. The CT and MRI findings of the lesions were similar. All of them showed obvious enhancement in arterial phase and continuous enhancement in venous phase, which were characterized by "fast in and slow out" in 4 out of 91 cases with Kasabach-Merritt syndrome. Conclusion: hepatic vascular lesions should also be named and classified according to ISSVA standard. Imaging is the first choice for diagnosis of hepatic vascular diseases in children.
【作者单位】：上海交通大学医学院附属上海儿童医学中心放射科;
【分类号】：R725.7;R816.92

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