中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
1期
1-5
,共5页
黄彬%蔡权宇%贾宁阳%程红岩
黃彬%蔡權宇%賈寧暘%程紅巖
황빈%채권우%가저양%정홍암
肝肿瘤%血管内皮瘤,上皮样%磁共振成像%体层摄影术,X线计算机
肝腫瘤%血管內皮瘤,上皮樣%磁共振成像%體層攝影術,X線計算機
간종류%혈관내피류,상피양%자공진성상%체층섭영술,X선계산궤
Liver%Hemangioendothelioma,neoplasms%Magnetic resonance imaging%Tomography,X-ray computed
目的 探讨肝上皮样血管内皮瘤(EHE)的影像特征,提高对该病的认识.方法 回顾性分析16例经病理证实的肝脏EHE的CT和MRI表现及临床资料,总结其影像特征.6例行CT检查,6例行MRI检查,4例同时行CT、MRI检查.其中4例采用磁共振弥散加权成像(DWI)序列.结果 16例肝脏EHE中,6例为单发,10例为多发.10例CT平扫呈不均匀较低密度,其中4例病灶内细小钙化灶.MRI T1WI显示病灶为不均匀低信号,T2WI及DWI上病灶均呈高信号.增强后8例示肝内静脉主干或分支终止于肿瘤的边缘,形成“棒棒糖征”.大于3 cm的病灶增强后有向心性强化倾向;小于3 cm的病灶呈边缘环形强化,门脉期及延迟期持续环形强化.观察病灶数目最佳时期为动脉期.结论 肝脏EHE在CT和MRI上表现具有一定特征性.尤其是“棒棒糖征”、CT平扫病灶内细小钙化以及增强后大于3 cm的病灶有向心性强化倾向,小于3 cm的病灶边缘持续环形强化,可为该病的鉴别诊治提供帮助.
目的 探討肝上皮樣血管內皮瘤(EHE)的影像特徵,提高對該病的認識.方法 迴顧性分析16例經病理證實的肝髒EHE的CT和MRI錶現及臨床資料,總結其影像特徵.6例行CT檢查,6例行MRI檢查,4例同時行CT、MRI檢查.其中4例採用磁共振瀰散加權成像(DWI)序列.結果 16例肝髒EHE中,6例為單髮,10例為多髮.10例CT平掃呈不均勻較低密度,其中4例病竈內細小鈣化竈.MRI T1WI顯示病竈為不均勻低信號,T2WI及DWI上病竈均呈高信號.增彊後8例示肝內靜脈主榦或分支終止于腫瘤的邊緣,形成“棒棒糖徵”.大于3 cm的病竈增彊後有嚮心性彊化傾嚮;小于3 cm的病竈呈邊緣環形彊化,門脈期及延遲期持續環形彊化.觀察病竈數目最佳時期為動脈期.結論 肝髒EHE在CT和MRI上錶現具有一定特徵性.尤其是“棒棒糖徵”、CT平掃病竈內細小鈣化以及增彊後大于3 cm的病竈有嚮心性彊化傾嚮,小于3 cm的病竈邊緣持續環形彊化,可為該病的鑒彆診治提供幫助.
목적 탐토간상피양혈관내피류(EHE)적영상특정,제고대해병적인식.방법 회고성분석16례경병리증실적간장EHE적CT화MRI표현급림상자료,총결기영상특정.6례행CT검사,6례행MRI검사,4례동시행CT、MRI검사.기중4례채용자공진미산가권성상(DWI)서렬.결과 16례간장EHE중,6례위단발,10례위다발.10례CT평소정불균균교저밀도,기중4례병조내세소개화조.MRI T1WI현시병조위불균균저신호,T2WI급DWI상병조균정고신호.증강후8례시간내정맥주간혹분지종지우종류적변연,형성“봉봉당정”.대우3 cm적병조증강후유향심성강화경향;소우3 cm적병조정변연배형강화,문맥기급연지기지속배형강화.관찰병조수목최가시기위동맥기.결론 간장EHE재CT화MRI상표현구유일정특정성.우기시“봉봉당정”、CT평소병조내세소개화이급증강후대우3 cm적병조유향심성강화경향,소우3 cm적병조변연지속배형강화,가위해병적감별진치제공방조.
Objective To investigate the imaging features of hepatic epithelioid hemangioendothelioma (EHE) and to improve the level of awareness of this disease.Methods A retrospective analysis was conducted on the CT and MRI findings and the clinical data of 16 patients with liver EHE.The diagnosis was made on specimens obtained by liver biopsy or with operation.Six patients received only CT,6 only MRI,4 both CT and MRI,and 4 with DWI sequence.Results 6 of 16 patients with hepatic EHE had a solitary tumor while the remaining 10 patients had multiple tumors.CT scanning on 10 patients showed a heterogeneous mass with low density.In 4 patients,there were small calcifications in the lesions.The lesions on MRI showed a heterogeneous mass with low signal in T1WI and high signal in T2WI and DWI.In 8 patients,during enhanced scanning,the intrahepatic vein and its branches terminated at the edge of the tumor to form the "lollipop sign." On the arterial phase lesions with a diameter ＞ 3 cm showed a centripetal enhancement pattern,which is similar to that of a haemangioma.Lesions with a diameter ＜ 3 cm showed ring enhancement and continuous annular enhancement in the portal venous phase and in the delayed phase.The best observation period for the number of lesions was in the arterial phase.Conclusion Hepatic EHE had certain distinct characteristics on CT and MRI,e.g.the "lollipop" sign,lesions with small calcification,lesions with a diameter ＞ 3 cm with a centripetal enhancement pattern,and lesions with a diameter ＜ 3 cm with continuous ring enhancement on CT scanning.These radiological features help in the diagnosis of the disease.
