原发性肝血管肉瘤的磁共振成像表现  

Magnetic resonance imaging findings of primary hepatic angiosarcoma

作　　者：卢琦 陈伶俐[3] 曾蒙苏 王明亮 Lu Qi;Chen Lingli;Zeng Mengsu;Wang Mingliang(Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;the Medic Imaging Center,the First Affiliated Hospital of Anhui University of CM,Hefei 230031,China;Department of Pathology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放射科,上海200032 [2]安徽中医药大学第一附属医院影像中心,合肥230031 [3]复旦大学附属中山医院病理科,上海200032

出　　处：《中华肝胆外科杂志》2023年第12期887-891,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨原发性肝脏血管肉瘤(PHA)的磁共振成像(MRI)特征。方法回顾性分析2011年10月至2022年8月在复旦大学附属中山医院就诊并经病理证实为PHA的15例患者的临床资料,其中男性9例,女性6例,年龄(57.4±11.5)岁。收集患者病灶的数目、部位、大小、形态、平扫信号强度、增强特征、表观扩散系数(ADC)值等。结果 15例患者中,4例为单发肿块型,10例为肿块结节型,1例为弥漫小结节型。15例患者中,11例(73.3%)为多发病灶,均累及肝左右叶。病灶大小不一,从点状到13.5 cm不等;共计分析肿块型病灶24枚、结节型病灶53枚。24枚肿块型病灶中不规整的有14枚;53枚结节型病灶中类圆形28枚,不规整型25枚。肿块型病灶较结节型病灶信号不均匀,100%(24/24)可见不同程度坏死区,91.7%(22/24)合并出血。24枚肿块型病灶增强动脉期以中央索条、网格状强化伴或不伴周边点、线、不完整环强化为主(66.7%,16/24);门静脉及延迟期逐步充实,因不同程度坏死或伴出血,无完全型充填强化。53枚结节型病灶动脉期主要以环形及整体强化方式为主(64.2%,34/53);门静脉期持续环形强化、向心性或网格充填及完全性强化。部分病灶较小或伪影干扰剔除后,实测病灶55枚,病灶ADC值为(1.57±0.54)×10^(-3) mm^(2)/s,同层邻近肝实质的ADC值为(1.36±0.30)×10^(-3) mm^(2)/s,两者比较,差异有统计学意义(P=0.012)。结论 PHA患者的MRI表现有一定的特征,特别是灶内血管穿行及畸形血管较具特征,结合临床及实验室检查,有助于疾病的诊断。Objective To investigate the magnetic resonance imaging(MRI)characteristics and pathological imaging findings of primary hepatic angiosarcoma(PHA).Methods A retrospective analysis was conducted on the clinical,pathological and MRI data of 15 cases of PHA confirmed by pathology at the Affiliated Zhongshan Hospital of Fudan University from October 2011 to August 2022,including 9 males and 6 females,aged(57.4±11.5)years old.The MRI data included the number,location,size,morphology,signal intensity on non-contrast MRI,enhancement features,and apparent diffusion coefficient(ADC)values of the lesions were collected.Results Among the 15 cases,4 presented as dominant masses,10 as multiple nodules,and 1 as diffuse small nodule type.Among the 15 patients,11(73.3%)had multiple lesions,all involving the left and right lobes of the liver.The size of the lesion varies from punctate to 13.5 cm.A total of 24 lumpy lesions and 53 nodular lesions were analyzed.Among the 24 lumpy lesions,14 were irregular.Among the 53 nodular lesions,28 were quasi circular and 25 were irregular.Compared to nodular lesions,the signal of lumpy lesions is uneven,with varying degrees of necrotic areas visible in 100%(24/24)and bleeding in 91.7%(22/24)of the cases.The arterial phase enhancement of 24 lumpy lesions was mainly characterized by central cord,grid like enhancement with or without peripheral points,lines,and incomplete ring enhancement(66.7%,16/24).The arterial phase of 53 nodular lesions mainly showed circular and overall enhancement(64.2%,34/53),while during the portal vein,continuous circular enhancement,centripetal or grid filling and complete enhancement were observed.After removing some small lesions or artifact interference,55 lesions were measured,and the ADC value of the lesions was(1.57±0.54)×10^(-3) mm^(2)/s,the ADC of adjacent liver parenchyma in the same layer was(1.36±0.30)×10^(-3) mm^(2)/s,the difference between the two was statistically significant(P=0.012).Conclusions The MRI manifestations of PHA patients have certain c

关 键 词：血管肉瘤 磁共振成像 扩散加权成像 病理 

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