原发性肝血管肉瘤的MRI影像学表现及病理分析  

MRI Imaging and Pathological Analysis of Primary Hepatic Angiosarcoma

作　　者：李妍卓 蔡权宇 贾宁阳[1] 陈栋[1] 邵丹丹[1] 陆伦[1] 程红岩[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院放射科

出　　处：《中国医学计算机成像杂志》2015年第2期118-123,共6页Chinese Computed Medical Imaging

摘　　要：目的:观察及分析原发性肝脏血管肉瘤(PHA)的MRI表现,结合其病理学基础及相关病理特点,以提高诊断准确性。方法:回顾性分析13例经手术病理证实行上腹部MRI三期增强扫描的PHA患者图像,分析其影像学及病理表现。结果:13例中8例为单发肿块型,2例为多发结节型,3例为巨块结节混合型。各病灶T1WI呈低信号,T2WI呈高信号,增强后早期病灶内呈斑片状及不规则片状不均匀强化,晚期呈进行性填充式强化。延迟期病灶内见不规则斑片状无强化区域。少数病灶延迟期与周围肝实质分界清楚,边缘可见"刀切征"和"假包膜征"。结论:PHA的MRI表现为块状及结节状T1WI低信号,T2WI高信号影,增强后病灶呈渐进性充填,与周围肝实质分界清楚,较大病灶内伴出血及坏死,通过上述特征性表现,有助于提高诊断率。Purpose：To observe the MRI findings of primary hepatic angiosarcoma（PHA） with its pathological features to improve its diagnostic accuracy.Methods：MRI and histopathological findings of13 cases of PHA,which were all pathologically confirmed,were analyzed retrospectively.All patients were undergone abdominal tri-phase dynamic contrast enhancement MRI scans.Results：Of all the patients,8cases were massive type,2 cases were multiple nodules type,and 3 cases were mixed type.All lesions were shown as hypo-intensity on T1 WI,heterogeneous hyper-intensity on T2 WI.Early phase contrast-enhanced images showed variable peripheral patchy or bizarre shaped enhancement,and the lesion presented as varying degrees of progressive enhancement at lately phases.Some patchy areas were not completely filled till delayed phase.Some large lesions had clear boundary with the surrounding liver parenchyma and were shown as ＂sharpen rim perpendicular to pleura＂ and ＂pseudocapsules＂ at the outer edges.Conclusion：PHA was shown as massive and nodular inhomogeneous hyper-intensity on T2 WI,hypo-intensity with patchy hyper-intensity area on T1 WI,and sustained progressive filling enhancement.At delayed phase,lesions had clear boundary with the surrounding liver parenchyma,some large lesions had hemorrhage and necrosis.It might be helpful to improve the diagnosis accuracy through the recognition of these characteristics on MR imaging.

关 键 词：肝肿瘤 血管肉瘤 磁共振成像 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学]