| 摘要: |
| 目的：总结分析我院肝脏上皮样血管内皮瘤（HEHE）的临床特点、影像学表现特征及预后情况，提高对该病的认识及术前诊断水平。方法：收集并分析自1999-2010年上海东方肝胆外科医院经病理证实的15例肝脏上皮样血管内皮瘤的临床影像学资料（包括CT、MRI表现）。结果：本组肝脏上皮样血管内皮瘤大部分未表现出典型的临床症状，只有7例感腹部不适。实验室检查亦无明显特异性，8例肝功能显示白球比降低，3例轻度贫血，1例谷丙转氨酶升高，所有病例AFP、CEA以及CA19-9均在正常水平；CT及MRI表现特征：大部分病例CT平扫表现为多发性不均匀低密度病灶，增强动态扫描显示动脉期肿瘤周边强化、门脉期周边进一步强化，延时扫描病灶可为环形强化；MRI T1加权像病灶为低信号，病灶中心信号更低。T2加权像病灶表现为稍高信号，病灶中心往往信号更高，增强扫描表现为环形强化，中心无明显强化，延迟期病灶进一步强化。预后情况：15例病人中有10例至今存活，其中包括4例带瘤生存。结论：认识肝脏上皮样血管内皮瘤的临床特点及影像学表现特征，了解其低度恶性的生物学特性，对于提高该病的认识和术前诊断水平以及积极的外科治疗，具有重要意义。 |
| 关键词: 肝上皮样血管内皮瘤；临床特点；影像学表现；外科治疗 预后 |
| DOI：10.3724/SP.J.1008.2014.00811 |
| 投稿时间：2013-03-14修订日期：2014-05-22 |
| 基金项目: |
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| Hepatic Epithelioid Hemangioendothelioma in our hospital : a clinical features and imaging findings study of 15 cases |
| fanfei,zhangyongjie |
| (Eastern Hepatobiliary Surgical Hospital) |
| Abstract: |
| Objective: To study the clinical features, imaging findings and prognosis of hepatic epithelioid hemangioendothelioma(HEHE)in Eastern Hepatobiliary Surgical Hospital, and to improve the level of recognition and preoperative diagnosis of HEHE. Methods: Clinical data of 15 pathology-confirmed HEHE patients, admitted in our hospital from 1999 to 2010 were collected and analyzed retrospectively. Results: Besides 7 cases of abdominal discomfort, this cohort of HEHE patients does not show common typical manifestations. Laboratory examinations found 8 low ALB/GLB (A/G) cases, 3 mild anemia cases, and 1 high alanine aminotransferase (ALT) case, but no abnormal AFP, CEA or CA19-9 cases. Plain computed tomography (CT) scanning found uneven multiple low-density lesions in most cases, and dynamic enhanced CT scanning demonstrated peripheral enhancement in hepatic arterial (HA) phase and more peripheral enhancement in portal vein (PV) phase, and ring enhancement were detected in delayed phase. Magnetic resonance imaging (MRI) demonstrated low signal intensity and even lower lesion centers in T1-weighted images (T1WI), but slightly high signal intensity lesions and higher lesion centers in T2-weighted images (T2WI). Enhanced MRI scanning showed ring enhancements but no obvious enhanced centers. Lesions were further enhanced in delayed MRI scanning. Prognosis of this cohort: ten of these 15 patients alive nowadays including four cases alive with the tumor. Conclusions: Comprehending the clinical and radiological characteristics of HEHE facilitates the level of recognition and preoperative diagnosis of this disease and promotes surgeons to take active and appropriate surgeries. |
| Key words: hepatic epithelioid hemangioendothelioma (HEHE) clinical features imaging findings surgical treatment prognosis |
