肝脏上皮样血管内皮瘤的影像学特征  

Imaging features of hepatic epithelioid hemangioendothelioma

作　　者：叶枫[1] 蒋力明[1] 宋颖[1] 马沛卿[1] 欧阳汉[1] 蔡建强[1] Ye Feng Jiang Liming Song Yiag Ma Peiqing Ouyang Han Cai Jianqiang(Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China)

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021

出　　处：《中华消化外科杂志》2017年第2期201-206,共6页Chinese Journal of Digestive Surgery

摘　　要：目的：总结肝脏上皮样血管内皮瘤（EHE）的影像学特征。方法：采用回顾性描述性研究方法。收集2012年6月至2016年6月中国医学科学院肿瘤医院收治的9例肝脏EHE患者的临床病理资料。患者行CT和MRI检查。由2名高年资影像科医师分析病灶的数目、大小、部位、形态、密度或信号、强化方式、有无病灶融合、与血管的关系等特征。病灶数量按肝左叶、肝右叶、肝尾状叶计数，5个以下计实数，否则计为≥5个。观察指标：（1）肝脏EHE的总体影像学特征。（2）肝脏EHE的MRI检查表现。（3）肝脏EHE的CT检查表现。（4）肝脏EHE的治疗和病理学特征及随访结果。患者经影像学检查后行相应治疗。术后采用门诊影像学检查方式进行随访，随访内容为肿瘤复发及病情稳定情况。随访时间截至2016年12月。结果：（1）肝脏EHE的总体影像学特征：9例肝脏EHE患者中，6例行MRI平扫及增强扫描，3例行CT平扫及增强扫描（1例同时行MRI检查），1例仅行CT增强扫描。肝右叶病灶数量多于肝左叶，肝尾状叶最少，病灶呈圆形或类圆形，病灶最大直径为2.5～6.1 cm，平均直径为3.6 cm。9例患者中， 4例总病灶数为2～5个，单叶肝脏病灶数量〈5个；病灶均无融合趋势，1例有晕环征及被膜皱缩，1例仅有晕环征。其余5例中2例有1个肝叶病灶数≥5个，3例有2个肝叶病灶数≥5个；4例均有晕环征、“棒棒糖”征、被膜皱缩及病灶融合趋势，1例有晕环征及被膜皱缩。9例患者中，出现晕环征 占7/9，“棒棒糖”征占4/9，肝被膜皱缩占6/9，病灶融合趋势占4/9。（2）肝脏EHE的MRI检查影像学表现：6例患者行MRI平扫及增强扫描检查。①4例患者T2加权成像和增强扫描门静脉期、肝胆期显示晕环征较好：3例T2加权成像表现为中心较高信号，外围稍高信号厚环；1例表现为中心较高信号，外周稍低薄�Objective：To analyze and summarize the imaging features of hepatic epithelioid hemangioendothelioma （EHE）. Methods：The retrospective and descriptive study was conducted. The clinicopathological data of 9 patients with EHE who were admitted to the Cancer Hospital of Chinese Academy of Medical Sciences between June 2012 and June 2016 were collected. Patients underwent computed tomography （CT） and magnetic resonance imaging （MRI） examinations. Number, size, location, shape, density or signal and enhancement method of lesions, with or without lesions fusion and relationship between lesions and vessels were analyzed by 2 imaging doctors. Lesions in left lobe of liver, right lobe of liver and caudate lobe of liver were respectively counted. Real number was a standard as less than 5 lesions and more than or equal to 5 lesions was represented as ≥5. Observation indicators： （1） overall imaging features of EHE; （2） MRI findings of EHE; （3） CT findings of EHE; （4） treatment and pathological features of EHE and results of followup. Patients received the corresponding treatment after imaging examinations. Followup using outpatient imaging examinations was performed to detect tumor recurrence and stable condition of patients up to December 2016. Results：（1） Overall imaging features of EHE： of 9 patients with EHE, 6 received plain and enhanced scans of MRI, 3 received plain and enhanced scans of CT （1 combined with MRI）, 1 received enhanced scan of CT. Lesions in right lobe of liver were more than that in left lobe of liver, and there were fewest lesions in caudate lobe of liver. Lesions were round or similarround shape, with a maximum diameter of 2.5-6.1 cm and an average diameter of 3.6 cm. Four patients had total 2-5 lesions and less than 5 lesions in each lobe of liver, without lesions fusion, including 1 with “halo” sign and “capsule retraction” sign and 1 with “halo” sign. Of other 5 patients, 2 had more than or equal to 5 lesions in each lobe of liver and 3 had

关 键 词：肝脏上皮样血管内皮瘤 体层摄影术 磁共振成像 诊断 

分 类 号：R735.7[医药卫生—肿瘤]