婴儿型肝血管内皮细胞瘤的影像学诊断价值  

The diagnostic value of imaging in infantile hepatic hemangioendothelioma

作　　者：方必东[1] 王毅[2] 陈晓晶[2] 陶元萍[1] 许崇永[1] 

机构地区：[1]温州医科大学附属第二医院放射科,浙江温州325027 [2]温州医科大学附属第一医院营养科,浙江温州325027

出　　处：《肝胆胰外科杂志》2014年第3期211-213,217,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨婴儿型肝血管内皮细胞瘤的影像学表现及诊断价值。方法回顾性分析15例婴儿型肝血管内皮细胞瘤的影像学表现,所有病例均行超声检查,10例行CT检查,7例行MRI检查。结果 15例中,单发病灶9例,多发病灶6例。影像学特点:肝内单发、多发及弥漫性结节或肿块,边界多清晰,病灶内或周围可见丰富血管影。超声以低回声为主,也可为高回声或混杂回声,多普勒超声检查示病灶血供丰富。CT平扫呈低密度灶,伴有斑点、斑片、条索状钙化。增强扫描示小病灶动脉期均匀明显强化或环行强化,延迟期持续强化;大病灶动脉期边缘呈环形及花瓣样强化,延迟期持续向心性强化,中心区域可见条索状血管样强化及未强化区域。MRI表现为不均匀长T1长T2信号,混杂出血、坏死及迂曲流空血管。结论婴儿型肝血管内皮细胞瘤影像学表现具有一定特征。超声应作为筛查和随访的重要手段,CT和MR对早期定性诊断有帮助。Objective To explore the imaging manifestation and the diagnostic value of infantile hepatic hemangioendothelioma （IHHE）.Methods The clinical and imaging findings of IHHE in 15 cases were retrospectively reviewed.All cases underwent ultrasound examination,10 cases underwent CT and 7 cases underwent MRI.Results Among 15 cases,there were 9 cases with single mass and 6 cases with multiple masses.All masses had clear margin.Ultrasound examination mainly demonstrated hypoechoic,and also demonstrated hyperechoic or mixed echoic lesions with rich blood supply.On CT scan,the hypodense masses mixed with spot,patch and cordlike calcifications.On enhanced scan,small lesions appeared homogeneous or ring-like enhancement at arterial phase,and continued to enhance at delay phase,while large lesions demonstrated ring or petal-like enhancement from periphery to center at arterial and portal phase,the density of tumors was equal or slightly higher comparing with the normal hepatic parenchyma at delay phase.In the center,there were some vascular-like enhancement and some necrosis without enhancement.The tumors showed inhomogeneous low signal on T1WI and high signal on T2WI.It mixed hemorrhage,necrosis or tortuous flowing void vessels.Conclusion The imaging appearances of IHHE have some characteristics.Ultrasound examination should be used as an important method of screening and follow-up,CT and MR has some value for early diagnosis.

关 键 词：婴儿型肝脏血管内皮细胞瘤 超声 磁共振影像 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]