肝脏上皮样血管内皮细胞瘤超声表现及文献复习  

Ultrasound features and literature review for hepatic epithelioid hemangioendothelioma

作　　者：张芳芳[1] 王宇翔[1] 薛改琴[1] 郭荣荣[1] 苗燕 ZHANG Fangfang;WANG Yuxiang;XUE Gaiqin;GUO Rongrong;MIAO Yan(Department of Ultrasound,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,Shanxi Province,China)

机构地区：[1]山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院超声室,山西太原030013

出　　处：《肿瘤影像学》2023年第2期178-181,共4页Oncoradiology

摘　　要：目的:分析肝脏上皮样血管内皮细胞瘤(hepatic epithelioid hemangioendothelioma,HEHE)的超声声像图特征,提高术前超声对HEHE的诊断准确度。方法:对9例病理学检查确诊为HEHE的患者的常规超声及超声造影(contrastenhanced ultrasound,CEUS)表现进行回顾性分析,总结HEHE声像图特征并复习相关文献。结果:9例HEHE患者肿物均为多发占位性病变,位于肝被膜下(部分外凸)或紧邻肝内血管(呈“棒棒糖样”),所有肿物形态尚规则,内部回声不均匀;1例为高回声伴声晕,其余为低回声;2例边界不清,7例边界清。CEUS动脉期环状高增强,门脉期及延迟期为低增强伴中心局部持续不增强,增强模式表现为“快进快出”特点。结论:HEHE的术前超声诊断比较困难,临床工作中遇到肝肿瘤分布在肝包膜下或紧邻肝内血管(呈“棒棒糖样”),CEUS后出现病灶环周增强,中央不增强的“快进快出”的乏血供特点,应考虑到HEHE。Objective:To analyze the ultrasonographic features of hepatic epithelioid hemangioendothelioma(HEHE)and to improve the accuracy of preoperative ultrasonography.Methods:A retrospective analysis was performed on the routine ultrasound findings and contrast-enhanced ultrasound(CEUS)characteristics of 9 HEHE patients diagnosed by pathological examination,and the relevant literatures were reviewed.Results:The tumors in 9 patients with HEHE were all multiple mass-occupying,located under the liver capsule(partially convex)or close to the intrahepatic blood vessels(lollipop-like).All the tumors had regular morphology and uneven internal echo,1 case was hyper-echoic with acoustic halo,and the rest were hypo-echoic.Two cases had unclear borders and 7 cases had clear borders.CEUS features:annular hyperenhancement in arterial phase,low enhancement with portal venous phase and delayed phase.The central part was not continuously enhanced,and the enhancement mode was characterized by fast-in and fast-out.The pathological diagnosis was HEHE.Conclusion:Preoperative ultrasound diagnosis of HEHE is difficult.In clinical work,liver tumors are distributed under the liver capsule or close to the intrahepatic blood vessels(lollipop-like).The lesions with characteristics of enhanced around the periphery and fast-forward without central enhancement after CEUS,HEHE should be taken into account.

关 键 词：肝脏上皮样血管内皮细胞瘤 超声 超声造影 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]