肝海绵状血管瘤CT“血池匹配”临床意义  

Clinical significance of “Matching blood pool” on CT in cavernous hepatic hemangioma

作　　者：周春山[1] 张金坤[2] 

机构地区：[1]江苏省淮安市淮阴医院放射科,江苏淮安223300 [2]江苏省淮安市第一人民医院放射科,江苏淮安223300

出　　处：《医学影像学杂志》2017年第11期2147-2149,共3页Journal of Medical Imaging

摘　　要：目的探讨肝脏海绵状血管瘤(cavernous hemangioma of liver,CHL)CT多期动态增强扫描中瘤体各期强化密度与血池(腹主动脉、门静脉及肝静脉)密度匹配的诊断价值。方法经炫速双源CT多期动态增强扫描,并经手术、病理(12例)或随访2年以上(43例)证实的肝血管瘤55例共60个瘤体进行总结分析。结果按瘤体最大横径﹤15mm、15~50mm、﹥50mm将60个瘤体分为小(16个)、中(35个)、大(9个)三种。目测平扫CHL密度除少数有钙化、脂肪变、出血、血栓及纤维化引起的高或低密度区外,都与血池密度匹配。目测60个CHL的动脉期仅部分强化灶与腹主动脉匹配,而且瘤体越大,匹配的强化灶越少;门脉期强化密度都与门静脉匹配,但有少数大的瘤体内的少数强化密度停留在动脉期密度;延迟期瘤体强化密度皆与血池密度匹配。结论肝血管瘤CT"血池匹配"现象反映了CHL由大小不等血管腔(血窦)组成,并由肝动脉、门静脉共同承担血供的病理特性,对肝血管瘤的CT诊断有重要价值。Objective To explore the diagnostic value of ＂matching blood pool＂ of CHL on muhiphase dynamic enhanced CT scanning. Methods A total of sixty tumors in the fifty-five cases with CHL underwent the dazzle dual-source CT multiphase dy- namic enhanced scan and confirmed by operation and pathology or follow-up of more than 2 years were analysed. Results Sixty tumors were divided into small（ 16）, medium（ 35 ）and big（9）according to the tumors that had the largest diameter 〈 15 mm, 15 - 50 mm and 〉 50 mm. The density of fifty one tumors under medium size matched blood pool （ abdominal aorta, portal vein and hepatic vein） density, two tumors matched the areas in addition to calcium, fat, hemorrhage, thrombosis and scar also matched blood pool in seven tumors among nine big tumors on plain CT. Enhancing area matching blood pool can find in the sixty tumors, but the bigger tumor had matched the less matching region and only a few matched regions in three tumors 〉 10 cm of the largest diameter on artery phase. The enhancing density had matched blood pool, but a few enhancing dots of the individual tumors stayed inarterial phase on portal phase. Total tumors had matched blood on delayed phase. Conclusion CT ＂matching blood pool＂ of CHL reflects the pathological characteristic that the tumors composed of blood sinus and are supplied collectively by hepatic arteri- al and portal vein, so having important value for CT diagnosis of CHL.

关 键 词：肝脏海绵状血管瘤 体层摄影术 X线计算机 血池匹配 

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