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肝血管源性恶性肿瘤的CT和MRI诊断 预览

CT and MRI diagnosis of malignant hepatic vascular tumors
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摘要 目的:总结分析肝血管源性恶性肿瘤的CT及MRI表现,提高其影像诊断水平。方法:回顾性分析经手术病理证实的11例肝血管源性恶性肿瘤患者的临床及影像学资料,其中10例行MRI扫描,1例行CT扫描,所有患者均行平扫及三期动态增强扫描。结果:11例肝血管源性恶性肿瘤中,肝上皮样血管内皮瘤(EHE)5例,肝血管肉瘤(PHA)3例,肝血管外皮细胞瘤(HPC)3例。5例肝EHE边界均清晰,其中3例为孤立结节,2例为多发结节并相互融合,3例病灶位于包膜下;1例出现肝“包膜凹陷”征,2例出现“晕”征;1例CT平扫呈低密度,中心见更低密度区;2例T 1WI平扫呈高低混杂信号,2例呈低信号;2例T 2WI呈高低混杂信号,2例呈高信号;增强扫描动脉期3例肿瘤边缘强化,2例肿瘤内出现片状或点状不均匀强化;延迟期均表现为持续强化,其中2例强化范围扩大。3例肝PHA边界均清晰,其中2例为单发巨块型;在T 1WI及T 2WI中均表现为高低混杂信号,增强扫描动脉期2例肿瘤内出现片状或点状不均匀强化及非周边强化,1例肿瘤边缘花边样强化;延迟期均表现为持续强化,强化范围均扩大。3例肝HPC中2例边界清晰,1例边界不清;在T 1WI及T 2WI中均表现为高低混杂信号;增强扫描动脉期3例肿瘤边缘均出现环状不均匀强化;延迟期2例边缘持续填充强化,未向中心填充;1例向内略填充。结论:肝血管源性恶性肿瘤的影像表现复杂多样,CT和MRI表现对判定肿瘤起源及与其它肿瘤的鉴别诊断有一定价值,确诊需依靠免疫病理检查。 Objective:The purposes of this study were to investigate the CT and MR manifestations of malignant hepatic vascular tumors and to improve diagnostic imaging skills.Methods:The clinical data,MR and CT findings of 11 cases of patients with malignant hepatic vascular tumors confirmed by surgery and pathology were analyzed retrospectively.Among them,10 cases underwent MR scan and 1 case CT scan.All MRI and CT scan protocols were following a dynamic triple phase contrast-enhanced scan.Results:Among the 11 cases,5 cases were hepatic epithelioid hemangioendothelioma(HEHE),3 hepatic angiosarcoma(HAS)and 3 hepatic hemangiopericytoma(HPC).The lesion margin of HEHE was clear in 5 cases,3 of them presented as isolated nodules,2 were multiple fusion nodules,and 3 lesions were under the liver capsule.One case showed hepatic"capsular retraction"sign and 2 cases showed"halo"sign.One case presented hypodense on plain CT scan,and a lower density area in the central part.2 cases presented high and low mixed signal intensity and 2 cases presented low signal intensity on T 1 weighted images.2 cases showed high and low mixed signal and 2 cases showed high signal intensity on T 2 weighted images.On arterial phase image,3 cases had marginal enhancement and 2 cases showed as patchy or punctate inhomogeneous enhancement.All lesions had the feature of continuous enhancement on delayed phase image,of which the enhancement range was enlarged in 2 cases.The 3 cases of HAS had clear margins,2 of them were single giant mass.They all showed mixed high and low signal intensity on both T 1 and T 2 weighted images.2 cases of HAS appeared patchy or punctate inhomogeneous enhancement and non-peripheral enhancement on arterial phase image.One case of HAS showed continuous lace-like and gradually enhanced pattern.Of the 3 cases of HHPC,2 cases had clear margins and 1 case not.Both presented mixed signals on T 1 and T 2 weighted images.All 3 cases showed heterogeneous ring-like enhancement on arterial phase image,and 2 cases had continuous peripheral en
作者 陆伦 郑魏 潘兴朋 李贺林 贾宁阳 霍雷 LU Lun;ZHENG Wei;PAN Xing-peng(Department of Radiology,Eastern Hepatobiliary Surgery Hospital,Shanghai 200438,China)
出处 《放射学实践》 北大核心 2018年第9期907-912,共6页 Radiologic Practice
关键词 肝肿瘤 体层摄影 X线计算机 磁共振成像 上皮样血管内皮瘤 血管肉瘤 血管外皮细胞瘤 Liver neoplasms Tomography,X-ray computed Magnetic resonance imaging Epithelioid hemangioendothelioma Angiosarcoma Hemangiopericytoma
作者简介 陆伦(1979-),男,上海人,主管技师,主要从事医学影像技术工作;通讯作者:霍雷,E-mail:leidfgd@163.com
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  • 1梁玉梅,李向红,吕亚莉,钟梅.肝脏梭形细胞恶性肿瘤的临床病理及免疫组织化学特点[J].中华医学杂志,2005,85(2):96-100. 被引量:6
  • 2Weiss SW,Enzinger FM.Epithelioid hemangioendothelioma:a vascular tumor often mistaken for carcinoma.Cancer,1982,50:970-981. 被引量:1
  • 3Ishak KG,Sesterhenn IA,Goodman ZD,et al.Epithelioid hemangioendothelioma of the liver:a clinicopathologic and followup study of 32 cases.Hum Pathol,1984,15:839-852. 被引量:1
  • 4Lyburn ID,Torreggiani WC,Harris AC,et al.Hepatic epithelioid hemangioendothelioma:sonographic,CT,and MR imaging appearances.AJR,2003,180:1359-1364. 被引量:1
  • 5Makhlouf HR,Ishak KG,Goodman ZD.Epithelioid hemangioendothelioma of the liver:a clinicopathologic study of 137 cases.Cancer,1999,85:562-582. 被引量:1
  • 6Kim KA,Kim KW,Park SH,et al.Unusual mesenchymal liver tumors in adults:radiologic-pathologic correlation.AJR,2006,187:W481-W489. 被引量:1
  • 7Miller WJ,Dodd GD 3rd,Federle MP,et al.Epithelioid hemangioendothelioma of the liver:imaging findings with pathologic correlation.A JR,1992,159:53-57. 被引量:1
  • 8Buetow PC,Buck JL,Ros PR,et al.Malignant vascular tumors of the liver:radiologic-pathologic correlation.RadioGraphics,1994,14:153-166. 被引量:1
  • 9Van Beers B,Roche A,Mathieu D,et al.Epithelioid hemangioendothelioma of the liver:MR and CT findings.J Comput Assist Tomogr,1992,16:420-424. 被引量:1
  • 10Earnest F,Johnson CD.Case 96:hepatic epithelioid hemangioendothelioma.Radiology,2006,240:295-298. 被引量:1

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