原发性肝脏血管肉瘤的螺旋CT表现  

Helical CT Appearances of Primary Hepatic Angiosarcoma

作　　者：徐嬿[1] 陈燕萍[1] 王琦[1] 吴芹[1] 刘彩霞[1] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《临床放射学杂志》2011年第9期1306-1309,共4页Journal of Clinical Radiology

摘　　要：目的分析原发性肝脏血管肉瘤(PHA)的螺旋CT表现,提高其诊断符合率。资料与方法回顾性分析6例经病理证实的PHA,进行上腹部螺旋CT平扫和三期动态增强扫描,使用GE Light Speed 16层螺旋CT机。评估病灶的数目、大小、形态、密度特点及动态增强后的强化程度。结果 6例中,弥漫多结节型4例,巨块型2例。6例CT平扫均呈低密度,均匀或不均匀。增强扫描动脉期,弥漫多结节型病灶大部分呈中心斑点状强化,少数病灶呈边缘结节状强化,随后病灶强化区域明显扩大而呈典型的渐进性强化特点;延迟扫描部分或全部病灶与肝实质呈等密度强化。巨块型病灶多呈小片状不均匀渐进性强化,整个病灶的强化程度低于肝实质及周围的血管。结论 PHA的CT表现为中心斑片状渐进性强化的特点,不典型时需与肝海绵状血管瘤及原发性肝细胞癌鉴别,最终确诊还需依靠病理及免疫组织化学。Objective To analyze helical CT findings of primary hepatic angiosarcoma（PHA）,and to improve its diagnostic accuracy.Materials and Methods A retrospective analysis of CT findings in plain and dynamic enhanced scanning was performed in 6 cases of PHA proved pathologically.The number,size,shape,intensity characteristics,the pattern and degree of enhancement of lesions were evaluated.Results PHA appeared as diffusely multiple nodules in 4 cases,and dominant masses in 2 cases.On plain CT scan,the PHA lesions appeared as heterogeneous or homogeneous hypodense area.Multiphase contrast-enhanced CT images showed heterogenous and progressive enhancement in multiple nodules.Focal regions of enhancement were located predominantly in the central portion of each lesion,with a few lesions located peripherally.The dominant masses demonstrated heterogeneous enhancement,most of which were hypoattenuated to both normal liver and vessels.Conclusion The CT feature of PHA is patchy progressive enhancement in the central portion of the lesions.Atypical PHA should be distinguished from cavernous hemangioma and hepatocellular carcinoma.The ultimate diagnosis relies on the pathological and immunohistochemical examination.

关 键 词：肝脏血管肉瘤 原发性 动态增强 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]