肝脏上皮样血管内皮瘤MRI征象  

MRI features of liver epithelioid hemangioendothelioma

作　　者：朱璐珑[1] 曹代荣[1] 王明亮 曾蒙苏 ZHU Lulong;CAO Dairong;WANG Mingliang;ZENG Mengsu(Department of Radiology,the First Affiliated Hospital of Fujian Medical University Fuzhou 350005,China;Department of Radiology,Zhongshan Hospital of Fudan University,Shanghai Institute of Medical Imaging,Department of Medical Imaging,Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]福建医科大学附属第一医院影像科,福建福州350005 [2]复旦大学附属中山医院放射科上海市影像医学研究所复旦大学上海医学院影像学系,上海200032

出　　处：《中国医学影像技术》2018年第7期1046-1049,共4页Chinese Journal of Medical Imaging Technology

基　　金：2016年福建省中青年教师教育科研项目(JZ160121)

摘　　要：目的观察肝脏上皮样血管内皮瘤(EHE)的MRI表现。方法回顾性分析经病理证实的18例肝脏EHE患者的MRI资料,观察肿瘤分布、大小、形状、边界、信号强度、强化方式等,探讨其MRI特征,并测量病变及周围正常肝组织的ADC值。结果18例EHE均为多发病灶,其中结节型10例,融合型8例。病变于平扫T1WI均呈低信号,16例T2WI呈"靶征"(边缘稍高信号伴中央更高信号),2例呈混杂信号;DWI均呈高信号,病灶ADC值为(1.58±0.25)×10^(-3 )mm^2/s,高于周围正常肝组织ADC值[(1.34±0.12)×10^(-3 )mm^2/s,t=4.014,P=0.001]。增强扫描10例结节型中7例呈环形渐进性向心强化,其中3例见"双环征",3例呈持续环形强化;8例融合型中,7例呈云絮状渐进性强化,1例呈环形渐进性向心强化。16例病灶内见血管穿行,13例血管止于病灶边缘或病灶内,15例伴肝包膜回缩。结论肝脏EHE的MRI表现具有一定特征性,有助于诊断和鉴别诊断。Objective To investigate MRI features of liver epithelioid hemangioendothelioma（EHE）.Methods MRI data of 18 patients with pathologically proven liver EHE were retrospectively reviewed.The tumor location,size,shape,margins,signal intensity and contrast enhancement patterns were observed.ADC value was measured and compared between the lesions and surrounding normal liver.Results All 18 patients had multi-lesions,including 10 nodular type and 8 fusion type.The lesions presented hypointensity on T1WI.The target sign（slight hyperintensity in the margin with marked hyperintensity at the center of lesions）was seen on T2WI in 16 patients,while mixed signal intensities were noticed in the other 2 patients.All lesions showed hyperintensity on DWI,and ADC value of the lesions was（1.58±0.25）×10^-3mm^2/s,higher than that of the surrounding normal liver（[1.34±0.12]×10^-3mm^2/s,t=4.014,P=0.001）.Among nodular type lesions,the centrality and ring centripetally enhancement was seen in 7 patients,including double-ring sign in 3 patients,while the persistent ring-enhancement was seen in the other 3 patients.Among fusion type lesions,the irregular inhomogeneous centripetally enhancement with cotton-shaped was found in 7 patients and ring-shaped in 1 patients.The sign of vessels passing through the lesions were found in 16 patients,vessels breaking down in the lesions or edge in 13patients and hepatic capsular retraction in 15patients.Conclusion MRI features of EHE of the liver have some characteristics,and should be helpful to characterization and diagnosis of liver EHE.

关 键 词：肝肿瘤 血管内皮瘤 上皮样 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]