肝上皮样血管内皮细胞瘤的影像表现  

Imaging Features of Epithelioid Hemangioendothelioma of the Liver

作　　者：石双任[1] 陈宏伟[1] 陆志华[2] 

机构地区：[1]南京医科大学附属无锡市人民医院放射科,214023 [2]苏州大学附属常熟医院放射科,215500

出　　处：《临床放射学杂志》2011年第12期1839-1842,共4页Journal of Clinical Radiology

摘　　要：目的探讨肝上皮样血管内皮细胞瘤(epithelioid hemangioendothelioma,EHE)的影像表现特征。资料与方法回顾性分析经肝穿刺病理证实的5例肝EHE患者的CT表现。结果 5例CT平扫均表现为肝内多发低密度结节,大小不等,境界清楚,均未见明显钙化及包膜征象,病灶多位于肝周及肝包膜下。3例可见部分病灶有融合,1例可见局部肝包膜轻度凹陷形成"肝包膜凹陷征"。5例增强扫描动脉期病灶边缘轻度强化,门静脉期病灶进一步向心性强化,但病灶密度仍低于周围正常肝实质(呈低密度)。2例增强扫描部分病灶表现为边缘强化呈高密度,中央见无强化的低密度区,病灶周边可见薄层更低的环形低密度带形成"晕环征"。2例增强扫描示肝内静脉主干及分支逐渐变细伸向低密度的结节,终止于结节的边缘形成"棒棒糖征"。3例增强扫描可见部分病灶内有静脉分支存在或静脉分支在病灶内穿行。结论 "肝包膜回缩征"、"晕环征"及"棒棒糖征"是肝EHE的影像表现特征,尤其是"棒棒糖征"具有一定的特异性,有助于其诊断与鉴别诊断。Objective To investigate the imaging features of epithelioid hemangioendothelioma of the liver.Materials and Methods CT data of 5 patients with epithelioid hemangioendothelioma confirmed by liver biopsy and pathology were retrospectively analyzed.Results The tumors showed multiple,well-defined low density nodes without calcification and capsule.The lesions were mostly located adjacent to the hepatic capsule.The multiple nodes merged together in three patients.The ＂capsular retraction＂ sign was found in one patient.All leaions showed mild rim enhancement on arterial phase contrast CT images,and progressive enhancment on portal venous phase,but the density of the lesions were still lower than normal liver parenchyma.The contrast-enhanced CT images showed rim-like enhancement nodes with central low density area in 2 patients.The ＂halo＂sign formed by narrowed ring-like lower density around the lesions was also demonstrated in the 2 patients.Hepatic or portal veins terminated taperingly to the periphery of some low density nodes in two patients,which formed the＂lollipop＂ sign.Venous branches passed through lesions on the contrast-enhanced CT images were showed in three lesions.Conclusion The liver Capsular retraction sign,the lollipop sign and halo sign were characteristic imaging features of epithelioid hemangioendothelioma in liver.The lollipop sign has specificity in the diagnosis and differential diagnosis.

关 键 词：肝肿瘤 上皮样血管内皮细胞瘤 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤]