成人原发性肝脏肉瘤的螺旋CT诊断  

Spiral CT Diagnosis of Adult Primary Hepatic Sarcoma

作　　者：王宗盛[1] 周胜利[1] 李树芸[1] 吴华连[1] 张永刚[1] 

机构地区：[1]江苏省连云港市第一人民医院放射科,222002

出　　处：《临床放射学杂志》2007年第3期266-269,共4页Journal of Clinical Radiology

摘　　要：目的分析7例成人原发性肝脏肉瘤的螺旋CT表现,探讨CT对其诊断价值。资料与方法回顾性分析7例经手术病理证实的成人原发性肝肉瘤的CT征象,所有病例均行平扫及增强检查,其中肝血管内皮肉瘤、恶性间叶瘤、癌肉瘤各1例,平滑肌肉瘤4例。结果原发性肝肉瘤分血管及非血管源性两大类,均无肝硬化基础。血管源性(肝血管内皮肉瘤)表现为肝内多发低密度灶,强化明显,非血管源性(恶性间叶瘤)表现为肝内巨大单发囊性病灶,增强囊壁和分隔明显强化;癌肉瘤表现为混杂密度肿块伴有坏死囊变,增强实质部分强化;平滑肌肉瘤表现为肝内巨大低密度病灶,可伴有囊变及钙化,增强见边缘强化。结论成人原发性肝肉瘤的螺旋CT表现与病理类型有关,典型CT征象结合临床有助于对其诊断,确诊需依靠病理及免疫组织化学检查。Objective To analyze spiral CT appearances of adult primary hepatic sarcoma and discuss its diagnostic value, Materials and Methods CT findings of 7 cases with adult primary hepatic sarcoma proved pathologically and surgically were analyzed retrospectively. All cases were performed with plain and enhanced spiral CT scan. The lesions included hepatic angiosarcoma （ n = 1 ）, undifferentiated embryonal sarcoma （ n = 1 ）, c （n=1） and leiomyosareoma （n =4）. Results The primary hepatic sarcoma was divided into two typesvascular and nonvascular, all had not hepatic cirrhosis basis. Multiple low density foci with obvious enhancement were found in the vascular type, such as hepatic angiosarcoma. The appearances of nonvascular lesions were as the following ： solitary, huge cystic lesions with wall and septa obvious enhancement were found in malignant enbryonal sarcoma; mixed density mass with necrotic cystic change and solid portion enhanced obviously in carcinosarcoma; intrahepatic huge low density, cystic changes, calcification and margin enhancement were found in leiomyosarcoma. Conclusion The spiral CT appearances of adult primary hepatic sarcoma are correlated to pathological types. Combining typical CT signs with clinic symptoms are helpful to the diagnosis. The confirmed diagnosis depends on pathology and immune histochemistry.

关 键 词：成人 肝肿瘤 肉瘤 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]