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原发性肝血管肉瘤的CT和MRI表现 被引量:18

CT and MRI Manifestations of Primary Hepatic Angiosarcomas
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摘要 目的探讨肝血管肉瘤(PHA)的CT和MRI影像特征,提高诊断准确率。方法回顾性分析经病理证实的10例肝血管肉瘤患者的临床和影像检查资料,各例均行平扫及多期增强扫描,其中5例仅行CT扫描,5例行CT和MRI两种检查。结果10例PHA中,单发巨块型7例,多发结节型1例,混合型2例。4例巨块型病灶T1WI见片状高信号出血灶,3例巨块型病灶MRT2WI见杂乱流空血管影。增强扫描8个(8/12)巨块型病灶动脉期周边部呈中度至明显不均匀环状或不规则形强化,中心区见不规则索条状或结节状明显强化影;门脉期及延迟期持续强化,呈向心状和(或)离心状扩展,中心区均未完全填充。1例多发结节型病灶动脉期及门脉期中心见斑片状轻中度强化,延迟期持续强化,部分病灶各期未见明显强化。结论PHA的CT和MRI表现具有一定特征性,增强扫描具有较高的诊断价值,典型表现为动脉期周边部和中心区明显强化,门脉期及延迟期持续填充式强化,但多不能完全充填。 Objective To investigate CT and MRI characteristic manifestations of primary hepatic angiosarcoma (PHA) in order to improve its diagnostic accuracy. Methods The clinical and imaging materials of 10 patients with pathologieally-proved PHA were retrospectively analyzed. Both plain and multi-phase enhanced CT examinations were performed in all the 10 patients. Additional MRI scanning was employed in 5 patients. Results Among the 10 cases, solitary huge mass type was seen in 7, multiple nodule type in one and mixed type in two. In 4 cases with huge mass type, patchy high signal on T1WI, indicating bleeding, was demonstrated. In other three cases with huge mass type, disorderly flow-void vascular shadow on T2WI was detected. On enhanced scans, eight huge lesions showed moderate to marked peripheral inhomogeneous ring-like or irregular enhancement at arterial phase, which remained in portal and delayed phase and the central area of the lesion was not completely filled with contrast. In one case with multiple nodule type mild to moderate patchy enhancement at central area was revealed during the arterial and portal phase, and the enhancement was kept on in delayed phase. Some lesions showed no obvious enhancement in all phases. Conclusion Primary hepatic angiosarcoma carries certain CT and MRI characteristics features. Enhanced scanning plays an important role in making diagnosis of PHA. The typical imaging manifestation of PHA is moderate to marked enhancement at the peripheral and central area of the tumor during the arterial phase which remains in the portal and delayed phase, and usually in most cases the central area of the lesion can not be completely filled with the contrast.
作者 张伟 王兰荣 薛鹏 皇甫幼田 陈勇 杨文魁 马秀华 杨学华 ZHANG Wei, WANG Lanrong, XUE Peng, et al. (Department of Medical Imaging, Zhengzhou People' s Hospital,Zhenzhou, Henan Province 450003,P. R. China)
出处 《临床放射学杂志》 CSCD 北大核心 2014年第5期734-738,共5页 Journal of Clinical Radiology
关键词 肝肿瘤 血管肉瘤 体层摄影术 X线计算机 磁共振成像 Liver neoplasm Angiosarcoma Tomography X-ray computed Magnetic resonance imaging
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