肝脏恶性纤维组织细胞瘤的影像学表现  

Hepatic malignant fibrous histiocytoma of imaging characteristics

作　　者：戴平丰[1] 孟延锋[1] 邓丽萍[1] 刘标[2] 金梅[2] 章士正[1] 

机构地区：[1]杭州浙江大学医学院附属邵逸夫医院放射科,310016 [2]杭州浙江大学医学院附属邵逸夫医院病理科,310016

出　　处：《中华放射学杂志》2005年第8期855-859,共5页Chinese Journal of Radiology

摘　　要：目的提高对肝脏恶性纤维组织细胞瘤影像学表现的认识。方法回顾性分析4例经手术或活检病理证实的肝脏恶性纤维组织细胞瘤的影像学特点,其中包括CT4例,MRI2例,肝动脉DSA1例。结果4例肿瘤均位于肝右叶,肿瘤呈浸润性生长,与周围肝实质分界不清,3例侵犯肝包膜。4例CT平扫均表现为不规则形低密度灶,CT值28～36HU,其中2例可见片状稍高密度出血灶;增强扫描动脉期肿瘤实质呈轻度强化,CT值52～70HU,静脉期呈中度强化,CT值75～98HU,病灶内部中央坏死显著。2例表现为T1WI低信号,与肌肉信号相当,其中1例病灶内见片状等高信号影,T2WI为较高信号。1例DSA表现为肝动脉分支走行呈“抱球状”,实质期可见不规则肿瘤染色。结论肝脏恶性纤维组织细胞瘤的影像学表现主要为肿瘤向外浸润明显,边界不清,肿瘤内部坏死显著,实质部分所占比例很小,瘤内出血常见。Objective To enhance the understanding of imaging characteristics of hepatic malignant fibrous histiocytoma. Methods Four cases of hepatic malignant fibrous histiocytoma proven by pathology were examined by means of CT （ n = 4） , MRI （ n = 2 ） , and angiography （ n = 1 ）. Results All tumors of the four patients were located in the right lobe of the liver. The marginal contours were irregular. The tumors extended to the liver capsule in three patients. On CT, all tumors were hypodense （28 - 36 HU） on plain scan compared with surrounding liver parenchyma. Plaque-like slight hyper dentisites were seen in two patients. After contrast injection, the solid portion of the mass showed mild enhancement （ 52 - 70 HU ） in arterial phase, and moderate enhancement in venous phase （75 -98 HU ）. Obvious nonenhanced necrotic areas were seen in all cases. On MR images, the main signal intensity of the mass was hypointense on T1 -weighted imaging compared with the adjacent liver. Plaque-like hyper intensities were seen in one patients.The intensity of the masses were higher than that of the liver on T2-weighted images. Angiography of one patient showed displacement of hepatic vasculature by the mass on arterial phase and irregular tumor staining was seen on parenchyma phase. Conclusion The primary imaging character of hepatic malignant fibrous histiocytoma is apparently invasive with unclear border and massive necrosis in the central part, and intratumoral bleeding is common.

关 键 词：肝脏恶性纤维组织细胞瘤 影像学表现 磁共振成像 血管造影术 CT检查 

分 类 号：R735.7[医药卫生—肿瘤] R730.4[医药卫生—临床医学]