原发性肝血管肉瘤的CT和MRI表现-论文.pdf

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1、·734·临床放射学杂志2014年第33卷第5期腹部放射学原发性肝血管肉瘤的CT和MRI表现张伟，王兰荣，薛鹏，皇甫幼田，陈勇，杨文魁，马秀华，杨学华【摘要】目的探讨肝血管肉瘤(PHA)的cT和MRI影像特征，提高诊断准确率。方法回顾性分析经病理证实的10例肝血管肉瘤患者的临床和影像检查资料，各例均行平扫及多期增强扫描，其中5例仅行cT扫描，5例行cT和MRI两种检查。结果10例PHA中，单发巨块型7例，多发结节型1例，混合型2例。4例巨块型病灶T1wI见片状高信号出血灶，3例巨块型病灶MRT2WI见杂乱流空血管影。增强扫描8个(8／

2、12)巨块型病灶动脉期周边部呈中度至明显不均匀环状或不规则形强化，中心区见不规则索条状或结节状明显强化影；门脉期及延迟期持续强化，呈向心状和(或)离心状扩展，中心区均未完全填充。1例多发结节型病灶动脉期及门脉期中心见斑片状轻中度强化，延迟期持续强化，部分病灶各期未见明显强化。结论PHA的cT和MRI表现具有一定特征性，增强扫描具有较高的诊断价值，典型表现为动脉期周边部和中心区明显强化，门脉期及延迟期持续填充式强化，但多不能完全充填。【关键词】肝肿瘤血管肉瘤体层摄影术，x线计算机磁共振成像CTandMRIManifestationsof

3、PrimaryHepaticAngiosarcomasZHANGWei，WANGLanrong，XUEPeng，eta1．DepartmentofMedicalImaging，ZhengzhouPeople’sHospital，Zhenzhou，HenanProvince450003，P．R．China【Abstract】ObjectiveToinvestigateCTandMRIcharacteristicmanifestationsofprimaryhepaticangiosarcoma(PHA)inordertoimprovei

4、tsdiagnosticaccuracy．MethodsTheclinicalandimagingmaterialsof10patientswithpath—ologically-provedPHAwereretrospectivelyanalyzed．Bothplainandmulti-phaseenhancedCTexaminationswereperformedinallthe10patients．AdditionalMRIscanningwasemployedin5patients．ResultsAmongthe10cases

5、．solitaryhugemasstypewasseenin7，muhiplenoduletypeinoneandmixedtypeintwo．In4caseswithhugemasstype，patchyhighsignalonT1WI，indicatingbleeding，wasdemonstrated．Inotherthreecaseswithhugemasstype，disorderlyflow-voidvas—cularshadowonT2W1wasdetected．Onenhancedscans，eighthugelesi

6、onsshowedmoderatetomarkedperipheralinhomo—geneousring—likeorirregularenhancementatarterialphase．whichremainedinportalanddelayedphaseandthecentralar-eaofthelesionwasnotcompletelyfilledwithcontrast．Inonecasewithmuhiplenoduletypemildtomoderatepatchyen—hancementatcentralare

7、awasrevealedduringthearterialandportalphase，andtheenhancementwaskeptonindelayedphase．Somelesionsshowednoobviousenhancementinallphases．ConclusionPrimaryhepaticangiosarcomacarriescertainCTandMRIcharacteristicsfeatures．Enhancedscanningplaysanimportantroleinmakingdiagnosiso

8、fPHA．ThetypicalimagingmanifestationofPHAismoderatetomarkedenhancementattheperipheralandcentralareaofthetumordu