16层螺旋CT多期动态增强扫描对肝脏小血管瘤合并动静脉瘘的诊断  

Small Hepatic Hemangiomas with Arterioportal Shunts:Diagnosis with 16-slice Spiral CT Multi-Phase Dynamic Contrast-Enhanced Scanning

作　　者：曾燕[1] 赵建农[1] 淦伟[1] 罗银灯[1] 

机构地区：[1]重庆医科大学第二附属医院放射科,重庆400010

出　　处：《实用放射学杂志》2007年第10期1338-1340,1368,共4页Journal of Practical Radiology

摘　　要：目的探讨肝脏小血管瘤合并动静脉瘘在多层螺旋CT多期动态增强扫描的表现,分析其形成机制和影响因素。方法回顾性分析33例52个肝脏小血管瘤的多期动态增强CT表现,动静脉瘘的诊断标准为:肝动脉期病灶周围肝实质一过性楔形或不规则形强化区,在门静脉期和延迟期变为稍高密度或等密度;或者表现为动脉期在上述楔形强化区域同时可见到早显的细小门静脉分支影。分析肝脏小血管瘤合并动静脉瘘的几率与病灶强化方式的关系。结果52个肝脏小血管瘤病灶中13个(25%)出现动静脉瘘,均表现为肿瘤周围一过性强化区,其中有7个病灶动脉期在上述楔形强化区域同时可见到早显的细小门静脉分支影,在21个快速强化型瘤体中有11个(52.4%)合并动静脉瘘,而31个慢速强化的瘤体中仅仅有2个(6.5%)合并动静脉瘘(P<0.05)。结论肝脏小血管瘤合并动静脉瘘并非很少见。合并动静脉瘘的肝小血管瘤更容易出现在快速强化型瘤体中。Objective To investigate the multi - phase dynamic spiral CT findings of small hepatic hemangioma with arterioportal shunts,and to discuss its mechanism and influencing factors. Methods Multi - phase dynamic contrast - enhancement CT findings of 52 small hepatic hemangiomas in 33 cases were analyzed retrospectively. The criteria for diagnosing arterioportal shunts were as follow： ①Transient wedge - shape or irregularly shape homogenous enhancement in the liver parenchyma adjacent to the tumor on hepatic arterial phase and slight hyper - or iso - attenuation in the area on portal venous phase and delayed phase ;②Some branches of portal vein showed early appearance within the wedge - shaped homogenously hyper - attenuating area on the arterial phase. The correlation between the enhancement patterns of homangiomas and the prevalence of arterioportal shunts in small hepatic homangiomas were analyzed. Results Arterioportal shunts were found in 13 （25 % ） of 52 small hepatic hemangiomas, all of them showed transient wedge -shaped enhancement peripheral to the tumor and in 7 of 13 hemangiomas showed early enhancement of branches of the portal veins on the arterial phase. Eleven （52.4%） of the 21 small hepatic hemangiomas with rapid enhancement had arterioportal shunt shunts, whereas only 2 （6.5%） of the 31 hemangiomas with slow enhancement had arterioportal shunt shunts （ P 〈 0.05 ）. Conclusion Arterioportal shunts are not uncommonly seen in small hepatic hemagiomas. Hemanglomas with arterioportal shunts tend to show rapid enhancement.

关 键 词：肝脏 血管瘤 动静脉瘘 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]