肝上皮样血管内皮瘤的影像学特征  

Imaging features of hepatic epithelioid hemangioendothelioma

作　　者：陈建春 易凤连 邱永友 余太慧[3] 宋歌[4] LU Dewu CHEN Jianchun;YI Fenglian;QIU Yongyou;LU Dewu;YU Taihui;SONG Ge(Department of Radiology,Qingxi Hospital of Dongguan,Dongguan,Guangdong 523660,China;Functional Department,Qingxi Hospital of Dongguan,Dongguan,Guangdong 523660,China;Department of Radiology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou,Guangdong 510120,China;Department of Radiology,Zhejiang Tumor Hospital,Hangzhou,Zhejiang 310011,China)

机构地区：[1]东莞市清溪医院放射科,广东东莞523660 [2]东莞市清溪医院功能科,广东东莞523660 [3]中山大学孙逸仙纪念医院放射科,广东广州510120 [4]浙江省肿瘤医院放射科,浙江杭州310011 [5]不详

出　　处：《影像研究与医学应用》2023年第20期7-10,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:肝上皮样血管内皮瘤(HEHE)是一种罕见的肝脏肿瘤,诊断仍然困难,本研究旨在分析HEHE的CT和MRI特征,以提高诊断准确率。方法:回顾性分析6例经病理确诊HEHE患者的临床资料及CT、MRI图像,对病变的数目、分布、形态、大小、密度/信号、边界及强化特点进行观察分析。结果:本组男4例,女2例,年龄24~71岁。其中1例行CT和MRI检查,4例行CT检查,1例行MRI检查。6例均表现为肝多发结节/肿块,沿肝包膜下分布为主,病灶共计178个,最大病灶大小约83mm×28mm。5例行CT平扫病灶均呈低密度,2例行MRI扫描病灶T_(1)WI呈低信号,T_(2)WI呈高信号,弥散加权成像(DWI)呈高信号,部分呈环形高信号,4例可见病灶融合,CT和MRI增强扫描表现为环形强化、均匀强化、云絮状强化;2例均可见黑/白靶征,4例瘤内血管征,4例可见包膜收缩征,3例可见棒棒糖征。结论:HEHE的CT和MRI具有一定的影像学特征,特别是包膜收缩征、黑/白靶征、瘤内血管征、棒棒糖征,有助于病变的诊断与鉴别诊断。Objective Hepatic epithelioid hemangioendothelioma(HEHE)is a rare liver tumor,diagnosis is still difficult.This study aimed to analyze the CT and MRI features of HEHE in order to improve the diagnostic accuracy.Methods The clinical data,CT and MRI images of 6 patients with pathologically confirmed HEHE were analyzed retrospectively.The number,distribution,shape,size,density/signal,boundary and enhancement characteristics of the lesions were observed and analyzed.Results There were 4 males and 2 females,aged 24~71 years.Among them,1 case underwent CT and MRI examination,4 cases underwent CT examination and 1 case underwent MRI examination.All 6 cases showed multiple nodules/masses in the liver,mainly distributed around the liver,178 lesions in total,and the largest lesion size was about 83 mm×28 mm,5 cases showed low density on plain CT scan,2 cases showed low signal on T_(1)WI,high signal on T_(2)WI,high signal on diffusion weighted imaging(DWI),some showed annular high signal,4 cases showed focal fusion,and enhanced scan showed ring enhancement,uniform enhancement,cloud flocculent enhancement;Black/white target sign was seen in 2 cases,intratumoral vascular sign in 4 cases,capsule contraction sign in 4 cases,and lollipop sign in 3 cases.Conclusion CT and MRI of HEHE have certain imaging features,especially capsule contraction sign black/white target sign,intratumoral vascular sign,and lollipop sign,which are helpful to the diagnosis and differential diagnosis of lesions.

关 键 词：肝脏肿瘤 上皮样血管内皮瘤 电子计算机断层扫描 磁共振成像 棒棒糖征 

分 类 号：R445.2[医药卫生—影像医学与核医学]