肝脏上皮样血管内皮瘤的CT及MRI表现_高翔

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1、宁夏医学杂志2013年2月第35卷第2期NingxiaMedJ，Feb.2013，Vol35，No.2·123·文章编号:1001－5949(2013)02－0123－03·论著·肝脏上皮样血管内皮瘤的CT及MRI表现11112高翔，王金宁，欧阳继业，王维明，姚圣祥［摘要］目的分析肝脏上皮样血管内皮瘤(EHE)的CT及MRI表现，旨在提高认识和诊断水平。方法回顾性分析经病理证实的肝脏EHE7例，均行多排螺旋CT平扫和动态增强扫描;其中4例行MR检查，包括平扫和动态增强成像，3例行选择性肝动脉造影。

2、结果共检出病灶162个，最大直径3．0～150mm，病灶分布于肝脏各段，其中75个病灶紧邻肝包膜下生长。CT平扫7例患者共162个低密度灶，其中47个出现融合。1例患者病灶内见钙化，6例见“包膜回缩征”，增强扫描64个病灶呈晕征，且门脉期显示更清晰。4例患者MR检出66个病灶，T1WI均低信号，T2WI中高信号。4例均可见“包膜回缩征”，增强后43个病灶呈晕征。3例选择性血管造影显示肝实质边缘斑片状染色伴周围细小血管。结论肝脏EHE表现为多发弥漫结节，多位于肝包膜下生长，结节可融合，可具有晕征及包

3、膜回缩征，MRI对晕征的显示较CT好。［关键词］肝脏;上皮样血管内皮瘤;体层摄影术;X线计算机;磁共振成像［中图分类号］R445．3［文献标识码］ACTandMRIappearancesofhepaticepithelioidhemangioendotheliomaGAOXiang，WANGJin－ning，OUYANGji－ye，etal．DepartmentofRadiology，TheFirstPeople＇sHospitalofYinchuan，Yinchuan750001，China［A

4、bstract］ObjectiveToanalyzetheCTandMRIfeaturesofhepaticepithelioidhemangioendothelioma(EHE)，andimprovetheunderstandingofimagingfindingsanddiagnosticlevel．MethodsSevencaseswithhepaticEHEconfirmedbypathologywerestudiedretrospectively．Allcasesunderwentpla

5、inanddynamiccontrast－enhancedmulti－sliceCTexamination．Fourcasesunderwentaddi-tionalMRIincludingplainT1－weightedimaging(T1WI)，T2－weightedimaging(T2WI)anddynamiccontrast－enhancedscanningandthreecasesunderwentselectivehepaticarteriography．ResultsAtotalof

6、162lesionsanddiameterrangingfrom3．0mmto150mmwerefoundinvarioussegmentsoflivers．75outofthe162lesionsgrewadjacenttothehepaticcapsule．162hypodensenodulesin7caseswereshownonunenhancedplainCT，and47ofthemwereconfluent．Calcificationwasfoundin1case．“Capsularr

7、etraction”signwasfoundin6cases．64lesionsdemonstrated“halo”signonpost－contrastCT，andthissignwasmoreclearlydemonstratedontheportalvenousphase．In4casesunderwentMRI，66lesionswerefoundwithlowsignalintensityonT1WI，intermediatetohighsignalintensityonT2WI．The

8、“capsularretraction”signwasfoundinall4cases．43lesionsshowed“halo”signonpost－contrastMRI．Selectivehe-paticarteriographyshowedpatchystainintheperipheralareaofliverparenchymawithsmallvesselsaroundtheminthreecases．ConclusionHepaticEHEmaymanifestas