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肝脏不典型血管瘤的影像学表现探讨
詹茜1,卢明智2,邵成伟1*,左长京3,吕桃珍1,陆建平1
0
(1. 第二军医大学长海医院放射科,上海 200433
2. 第二军医大学长海医院放疗科,上海 200433
3. 第二军医大学长海医院核医学科,上海 200433
*通信作者)
摘要:
目的探讨肝脏不典型血管瘤的CT和MR表现特点。方法回顾性分析6例肝脏不典型血管瘤病例的CT和(或)MR检查平扫和增强扫描资料,总结其一般表现和特殊表现。结果肝脏血管瘤的“共性”表现有:(1)类圆形,边缘光整;(2)CT平扫表现为稍低密度,MRI平扫表现为稍长T1、长T2信号,其内密度或信号可不均匀,见瘢痕影;(3)增强扫描后,动脉期边缘结节状强化,门静脉期及延迟期强化向病灶内部推进、填充,呈典型的“早出晚归”表现,瘢痕不强化。肝脏不典型血管瘤的“个性”表现有:(1)病灶内瘢痕可发生囊变、坏死及钙化,或瘢痕生长过大,将整个瘤灶填充;(2)瘤灶出血,CT表现为病灶内密度增高影,MR表现为短T1、短T2异常信号改变;(3)瘤体可压迫邻近肝实质及脉管系统,发生继发性改变,如肝组织变形、血供异常、胆管梗阻等。结论典型的肝脏海绵状血管瘤不难诊断,当发生某些不典型表现时,仍需多方面观察、分析,作出正确诊断。
关键词:  肝脏肿瘤  不典型血管瘤  X线计算机体层摄影术  磁共振成像
DOI:10.3724/SP.J.1008.2011.01346
投稿时间:2011-04-28修订日期:2011-11-03
基金项目:基金号:30970801
Radiological characteristics of atypical hemangiomas of the liver
ZHAN Qian1, LU Ming-zhi2, SHAO Cheng-wei1*, ZUO Chang-jing3, Lü Tao-zhen1, LU Jian-ping1
(1. Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
2. Department of Radiotherapy, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
3. Department of Nuclear Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.)
Abstract:
ObjectiveTo explore CT and MR radiological characteristics of atypical hemangiomas of the liver (AHL). MethodsThe CT and MRI findings of 6 patients with pathologically proven AHL were retrospectively analyzed. ResultsThe common radiological findings of hemangiomas of the liver included:(1)The lesions were oval-shaped with smooth outline.(2)The lesions were of slightly hypodense on plain CT scan. On MRI scan,the lesions showed slightly low signal with T1WI and high signal with T2WI, and the lesions had central scars.(3)On dynamic contrast-enhanced CT or MRI scan,the lesions had peripheral nodular enhancement and a centripetal gradual fill-in pattern without enhancement of the central scars. The special radiological features of AHL included:(1)Necrotic or cystic changes and calcification could be found in the central scars.(2)Hemorrhage could also be observed in the lesions though it was rare;they had enhanced CT signal and aberrantly short T1 and T2 signals.(3)The lesions might compress the hepatic parenchyma,biliary and vascular structures, leading to secondary changes such as deformity, abnormal bloody supply, and bile duct obstruction. ConclusionDiagnosis of typical hemangiomas of the liver is not difficult. But more observation and analysis are needed to diagnose AHL.
Key words:  liver neoplasms  atypical hemangiomas  X-ray computed tomography  magnetic resonance imaging