肝脏硬化性血管瘤的CT及MRI表现  

CT and MRI features of sclerosed hemangioma of the liver

作　　者：贾翠宇[1] 赵大伟[1] 许少华[1] 王欣欣[1] 齐石[1] 宋文艳[1] 李雪芹[1] 陈枫[1] 张瑞池[1] 李宏军[1] 

机构地区：[1]首都医科大学附属北京佑安医院放射科,100069

出　　处：《中华放射学杂志》2017年第7期511-514,共4页Chinese Journal of Radiology

摘　　要：目的探讨肝脏硬化性血管瘤（HSH）的CT、MRI表现。 方法回顾性分析经手术及病理证实为HSH，且术前30 d内进行了多层螺旋CT检查的20例患者。20例均行肝脏CT平扫及三期增强扫描，4例还进行了肝脏MRI平扫及多期动态增强扫描检查。观察患者的影像表现，包括血管瘤发生部位、大小、形态、平扫的密度或信号特征和增强后的强化方式等。 结果20例HSH血管瘤最大径43~246 mm；呈类圆形5例，不规则形15例；肝右叶13例，肝左叶7例。CT平扫20例病变均为低密度，其中4例密度均匀，16例病变内可见不规则的更低密度区。CT增强扫描，16例动脉期病变边缘可见线状或结节样强化，静脉期显示强化呈向心性或向结节周围蔓延并持续到延迟期，病变内可见低密度无强化区；动脉期病变无明显强化4例，静脉期及延迟期病灶边缘或内部可见分隔样轻度强化，病变内呈大范围无强化区。4例病变在平扫T1WI上表现为低信号，内部见更低信号区；T2WI为轻至中度高信号，内部见更高信号区。DWI上病灶表现为不均匀高信号。MRI增强扫描，动脉期病变边缘呈小结节状强化，静脉期及延迟期表现不规则向心性强化，病变中央可见较大伴有更低信号的无强化区。 结论HSH的CT和MRI表现具有特征性，病变中央可见较大的无强化区。ObjectiveTo investigate CT and MRI features of hepatic sclerosed hemangioma （HSH）. MethodsCT and MRI findings were retrospectively reviewed in 20 cases of HSH, all of which were confirmed pathologically after hepatic surgery. Twenty patients underwent CT scan,4 patients underwent MRI. Meanwhile, the enhancement pattern and signal intensity were analyzed either. ResultsTwenty patients showed main part of tumor was hypo-attenuating on CT plain scanning, and 16 patients showed the central area of tumor was markedly more hypo-attenuating on CT plain scanning. After administration of intravenous contrast media, multifocal linear or small nodular enhancement in the peripheral area was seen during the arterial phase on 16 patients of HSH. Venous phases showed centripetal enhancement or spread around the nodules enhancement which continued to delayed phases with low density of no enhancement in the lesion area. Four patients showed no obvious enhancement on arterial phases and slight separation sample enhancement at the edge or inside of the lesions with a wide range of non enhancement areas on venous phase and delayed phase. Four patients were performed MRI examination, the lesions demonstrated hypointensity with a lower signal area on T1WI, hyperintensity with a higher signal intensity area on T2WI. The DWI sequence of b value were 0, 150, 800 s/mm2, all of which were obviously hypointensity. The edge of lesions showed small nodular enhancement on arterial phase, irregular concentric enhancement on venous phase and delayed phase, and there was no enhancement area with lower signal in the center of the lesion. ConclusionsThe enhancement pattern of HSH different from cavernous hemangioma, with a larger non enhancement area in the center of the lesions and similar to other hepatic masses with central scar, differential diagnosis dependence on CT and MRI dynamic enhanced scan.

关 键 词：肝脏肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R735.7[医药卫生—临床医学]