原发性肝肉瘤的螺旋CT表现（附6例报告并文献复习）  

Helical CT findings of primary hepatic sarcoma （report of 6 cases and literature review）

作　　者：平小夏[1] 孟倩[1] 黄周[1] 谢道海[1] 

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006

出　　处：《实用放射学杂志》2014年第5期818-821,共4页Journal of Practical Radiology

摘　　要：目的：分析成人原发性肝肉瘤的螺旋 CT 表现，以提高临床诊断准确率。方法回顾性分析6例经病理证实的原发性肝肉瘤的 CT 表现，其中血管肉瘤（PHA）2例，上皮样血管内皮瘤（EHE）、淋巴瘤（PHL）、腺泡状软组织肉瘤（ASPS）、未分化胚胎样肉瘤（UES）各1例。结果2例 PHA 中1例为多结节型，表现为肝内多发低密度灶，中央斑片状渐进性强化；1例为混合型，表现为肝右叶1个巨大病灶并肝内多发子灶。1例 EHE 表现为多灶性病变累及肝左右叶，病灶多位于肝脏的外周并延伸至肝脏边缘。1例 PHL 表现为肝左叶边界不清的稍低密度灶，增强后环形强化。1例 ASPS 表现为肝内边界清楚的低密度灶，动脉期明显不均匀强化。1例 UES 表现为肝右叶较大囊性密度影，增强后轻度边缘强化。结论成人原发性肝肉瘤的 CT 表现与病理类型有关，临床与典型 CT 征象相结合有助于诊断，最终确诊仍需依靠病理及免疫组织化学。Objective To improve the diagnostic accuracy by analyzing the CT features of primary hepatic sarcoma.Methods The CT findings of 6 cases with primary hepatic sarcoma confirmed by histopathology were analyzed retrospectively,including primary hepatic angiosarcoma 2 cases,and epithelioid hemangioendothelioma,primary hepatic lymphoma,alveolar soft-part sarcoma,undif-ferentiated embryonal sarcoma,1 case each.Results Primary hepatic sarcoma appeared as multiple nodules with heterogeneous and progressive enhencement in one case,and a dominant mass with multiple satellite nodules in another case.Epithelioid hemangioendo-thelioma displayed as multifocal hepatic disease involving both liver lobes,more than half of the lesions were peripheral and extended to the liver margin.Primary hepatic lymphoma demonstrated as an ill-defined low-density lesion with irregular ring enhancement. Alveolar soft-part sarcoma presented as a well-defined low-density lesion with obviously heterogeneous enhancement in arterial phase.Undifferentiated embryonal sarcoma appeared as a huge cystic lesion with slightly margin enhancement.Conclusion The CT findings of primary hepatic sarcoma are associated with the pathological types,combining clinical symptoms with typical CT features are helpful to the diagnosis.The ultimate diagnosis relies on pathology and immune histochemistry.

关 键 词：肝肿瘤 肉瘤 计算机体层成像 

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