肝脏硬化性血管瘤的CT和MRI表现分析  

Imaging Features of Hepatic Sclerosing Hemangioma

作　　者：杨晓燕[1] 王明亮 陈伶俐 曾蒙苏 YANG Xiao-yan;WANG Ming-liang;CHEN Ling-li;ZENG Meng-su(Department of Medical Imaging,Shenzhen TCM Hospital,Shenzhen 518000,Guangdong Province,China;Department of Medical Imaging,Fudan University Zhongshan Hospital,Shanghai 200032,China;Department of Pathology,Fudan University Zhongshan Hospital,Shanghai 200032,China)

机构地区：[1]深圳市中医院放射影像科,广东深圳518000 [2]复旦大学附属中山医院放射科,上海市老年医学中心放射科,上海200032 [3]复旦大学附属中山医院病理科,上海200032

出　　处：《中国CT和MRI杂志》2024年第3期103-105,共3页Chinese Journal of CT and MRI

基　　金：上海市临床重点专科项目(shslczdzk03202)。

摘　　要：目的 探讨肝脏硬化性血管瘤(HSH)的影像表现。方法 回顾性分析2013年至2021年复旦大学附属中山医院经病理证实的10例HSH患者的影像学资料6例行MR检查,2例行CT检查,2例行MR+CT检查。图像分析包括病灶数目、部位、大小、形态、边缘、密度或信号、强化方式、相邻肝包膜等影像学特征,并测量病灶与肝实质的ADC值,两者ADC值比较采用独立样本t检验。结果 10例患者均为单发病灶,大小(35.8±44.4)mm,8例类圆形、1例类椭圆形、1例分叶状,边缘均清楚。CT平扫均为低密度,2例轻度均匀持续强化,2例向心性强化;T1WI呈低、稍低信号,T2WI呈高信号、3例病灶内见低信号,增强扫描4例向心性强化,2例轻度环形持续强化,1例延迟强化,1例类似环形“快进快出”强化,病灶与肝实质的ADC值差异有显著统计学意义(P<0.01),3例出现相邻肝包膜皱缩现象。结论HSH影像表现不典型但具有一定特点:动脉期环形强化,门脉期及延迟期强化不减退,病灶ADC值高于肝实质ADC值。Objective To investigate the imaging features of hepatic sclerosing hemangioma(HSH).Methods10 cases of HSH confirmed by surgery and pathology in Fudan University Zhongshan Hospital from 2013 to 2021 were analyzed retrospectively.MRI examinations were performed in 8 cases and CT examination in 4 cases.The number of lesion,location,size,shape,CT density,MRI signal,adjacent liver capsule,enhancing pattern were analyzed.ADC values of lesions and liver parenchyma were measured,the ADC values were compared by independent sample t-test.ResultsAmong the 10 patients,all of which were single lesion,5 in the right lobe of the liver and 5 in the left lobe.The average size was(35.80±44.43)mm,8 cases had a round shape,1 oval,and 1 lobulated.CT scan showed low density,2 cases had no enhancement,and 2 cases had centripetal enhancement.In MRI scan,T1WI showed low and slightly low signal,T2WI showed high and slightly high signal,4 cases showed centripetal enhancement,2 cases showed mild circular enhancement,1 case showed delayed enhancement,1 cases showed circular enhancement in arterial phase and wash out in portal phase and delayed phase.DWI showed high signal,ADC high or slightly high signal.The ADC value of lesions was(1.732±0.217)×10–3mm2/s,ADC value of liver parenchyma was(1.316±0.192)×10–3mm2/s.The adjacent hepatic capsule shrank in 3 cases.ConclusionThe imaging features of HSH are not typical but have some characteristics.When the intrahepatic lesions show circular enhancement in arterial phase,and do not wash out in portal phase and delayed phase,and the ADC values of the lesions higher than liver parenchyma,the possibility of HSH should be considered.

关 键 词：肝脏 硬化性血管瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]