小肠上皮样血管肉瘤影像学特征  

Imaging characteristics of small intestinal epithelioid angiosarcoma

作　　者：丛振杰[1] 殷薇薇[2] 姜茂竹 董成功[4] 迟作强[5] 林志军[1] Cong Zhenjie;Yin Weiwei;Jiang Maozhu;Dong Chenggong;Chi Zuoqiang;Lin Zhijun(Department of Radiology,Yantaishan Hospital of Yantai,Yantai 264003,China;Department of Nuclear Medicine,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;The Second Department of Radiotherapy,Yantaishan Hospital of Yantai,Yantai 264003,China;Department of Pathology,Yantaishan Hospital of Yantai,Yantai 264003,China;Department of Imaging,Yantai Yuhuangding Hospital,Yantai 264099,China)

机构地区：[1]烟台市烟台山医院影像科,烟台264003 [2]温州医科大学附属第一医院核医学科,温州325000 [3]烟台市烟台山医院放疗二科,烟台264003 [4]烟台市烟台山医院病理科,烟台264003 [5]烟台毓璜顶医院影像科,烟台264099

出　　处：《中华消化外科杂志》2025年第3期394-400,共7页Chinese Journal of Digestive Surgery

基　　金：山东省医药卫生科技发展计划面上项目(2019WS270)。

摘　　要：目的探讨小肠上皮样血管肉瘤的影像学特征。方法采用回顾性描述性研究方法。收集2013年1月至2023年12月烟台市烟台山医院等全国3家医学中心收治的5例小肠上皮样血管肉瘤男性患者的临床资料;年龄为54(36~73)岁。5例患者均行CT平扫及动态增强扫描检查,其中1例同时行磁共振成像(MRI)平扫检查。观察指标:(1)CT和MRI检查情况。(2)手术和术后病理学检查情况。(3)随访情况。偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)CT和MRI检查情况。5例患者中,2例为原发性小肠上皮样血管肉瘤;3例为转移性小肠上皮样血管肉瘤。5例患者均无其他实质性脏器转移,均未发生明显腹水及腹膜转移。①2例原发性小肠上皮样血管肉瘤患者共检出3个小肠肿瘤,CT平扫检查均表现为类圆形软组织结节,以腔内生长为主,肿瘤CT值分别为30、35、32 HU;增强扫描检查动脉期肿瘤中度强化,肿瘤CT值分别为57、72、65 HU;静脉期明显强化,肿瘤CT值分别为76、86、88 HU;延迟期肿瘤强化程度略减低,肿瘤CT值分别为74、79、72 HU,肿瘤内未见明显坏死囊变。②3例转移性小肠上皮样血管肉瘤患者共检出4个小肠肿瘤,CT平扫检查均表现为小肠局部不均匀管壁增厚,肿瘤CT值分别为39、37、38、28 HU;增强扫描检查动脉期受累肠段轻度强化,肿瘤CT值分别为57、56、52、45 HU;静脉期肿瘤明显强化,肿瘤CT值分别为84、88、82、77 HU;延迟期肿瘤强化程度进一步增加或减低,肿瘤CT值分别为95、78、72、70 HU;1例MRI检查增厚肠壁T1加权成像呈低信号、T2加权成像抑脂呈不均匀高信号、扩散加权成像呈明显高信号、表观扩散系数图呈低信号。(2)手术和术后病理学检查情况。5例患者均完整切除肿瘤。2例原发性上皮样血管肉瘤患者3个小肠肿瘤中,2个肿瘤侵及浆膜层,1个肿瘤侵及黏膜下层。3例转移性上皮样血管肉�Objective To investigate the imaging characteristics of small intestinal epithelioid angiosarcoma.Methods The retrospective and descriptive study was conducted.The clinical data of 5 male patients with small intestinal epithelioid angiosarcoma who were admitted to 3 medical centers,including Yantaishan Hospital of Yantai et al,from January 2013 to December 2023 were collected.The age of 5 patients was 54(range,36−73)years.All 5 patients underwent computer tomography(CT)plain scan and dynamic contrast-enhanced scan,with 1 patient also undergoing magnetic resonance imaging(MRI)plain scan.Observation indicators:(1)results of CT and MRI examination;(2)surgical conditions and postoperative pathological examination;(3)follow-up.Measurement data with skewed distribution were represented as M(range),and count data were described as absolute numbers.Results(1)Results of CT and MRI examination.Of the 5 patients with small intestinal epithelioid angiosarcoma,two cases were primary small intestinal epithelioid angiosarcoma and the other three cases were metastatic small intestinal epithelioid angiosarcoma.None of the five patients exhibited metastasis to other solid organs,and no significant ascites or peritoneal metastases.①In two cases of primary small intestinal epithelioid angiosarcoma,three tumors were identified,appearing as round soft tissue nodules on CT plain scan,primarily growing intraluminally.The CT value for tumors of those two cases on plain scan were 30,35,32 HU,respectively.During the arterial phase of enhanced CT scan,moderate enhancement was observed for tumors of those two cases,with CT value of 57,72,65 HU,respectively.During the venous phase of enhanced CT scan,significant enhancement was observed for tumors of those two cases,with CT value of 76,86,88 HU,respectively.During the delayed phase of enhanced CT scan,slightly decreased enhancement was observed for tumors of those two cases,with CT value of 74,79,72 HU,showing no significant necrosis or cystic changes within the tumors.②In three cases o

关 键 词：肠肿瘤 上皮样血管肉瘤 X射线计算机体层摄影 磁共振成像 特征 

分 类 号：R735.3[医药卫生—肿瘤]