摘要
目的 探讨CT对原发性肝肉瘤的诊断价值。方法 回顾性分析 12例经手术病理证实的原发性肝肉瘤的CT表现 ,包括平滑肌肉瘤、脂肪肉瘤及恶性纤维组织细胞瘤各 2例 ,血管肉瘤、癌肉瘤、囊腺癌肉瘤、间皮肉瘤、纤维肉瘤、恶性淋巴瘤各 1例。结果 12例原发性肝肉瘤中仅 2例脂肪肉瘤术前CT诊断正确。对照手术病理所见 ,肝肉瘤的CT表现可概括为实质性肿块型和囊性肿块型两种类型。实质性肿块型 8例 ,包括脂肪肉瘤 2例 ,平滑肌肉瘤、血管肉瘤、癌肉瘤、间皮肉瘤、纤维肉瘤、恶性淋巴瘤各 1例。CT平扫为均匀或不均低密度灶 ,增强扫描病灶无明显强化 ,或者呈不均强化、环形边缘强化或边缘结节状强化。边缘强化是血管肉瘤和恶性淋巴瘤共有的特点。以脂肪密度为主、内含多发条索状结构的肿块是脂肪肉瘤的特征性表现。囊性肿块型 4例 ,包括恶性纤维组织细胞瘤 2例 ,平滑肌肉瘤术后复发及囊腺癌肉瘤各 1例。均为单发巨大囊性肿块 ,其中平滑肌肉瘤术后复发者为单房囊性肿块 ,其他 3例为多房囊性肿块 ,囊壁和 (或 )分隔厚薄不均 ,增强扫描囊壁和分隔有明显强化。囊腺癌肉瘤的囊性肿块内可见明显实质成分 ,并可见壁结节。结论 肝肉瘤的CT表现与病理类型有关 ,部分病理类型如脂肪肉瘤、血管肉瘤有一定特征性CT表现 ,大?
Objective To assess the diagnostic value of CT to primary hepatic sarcoma. Methods The CT findings of 12 cases of primary hepatic sarcomas confirmed by operation and pathology, including leimyosarcoma, liposarcoma, and malignant fibrous histocytoma, 2 cases each, and angiosarcoma, carcinosarcoma, cystadenocarcinosarcoma, mesotheliosarcoma, fibrosarcoma, and malignant lymphoma, one case each, were analysed retrospectively. Results Only 2 out of the 12 cases of primary hepatic sarcoma were correctly diagnosed by CT before operation. The CT manifestations of primary hepatic sarcoma, against the operational and pathological findings, could be summarized as two types: solid mass type and cystic mass type. Eight cases were of solid mass type, including 2 cases of liposarcoma, and leiomyosarcoma, angiosarcoma, carcinosarcoma, methotheliosarcoma, fibrosarcoma, and malignant lymphoma, one case each. Plain scanning showed homogeneous or inhomogeneous low density masses; enhanced scanning showed no marked enhancement or inhomogeneous enhancement, ringed peripheral enhancement, or nodular peripheral enhancement. Peripheral enhancement was a CT feature common to angiosarcoma and lymphoma. The characteristic CT manifestation of liposarcoma was an inhomogeneous mass with well defined border and multiple intermingled septa. Four cases were of cystic mass type, including 2 cases of malignant fibrous histocytoma, and leimyosarcoma with post operative recurrence and cystadenocarcinosarcoma, one case each, all manifesting a huge single cystic mass: unilocular in the case of leimyosarcoma with post operative recurrence and multilocular in the other 3 cases. The wall and/or septa of the cyst had an uneven thickness and were markedly enhanced after contrast administration. Clear solid element and wall nodules were seen in the cystic mass of cystadenocarcinosarcoma. Conclusion The CT findings of primary hepatic sarcoma are associated with the pathology of tumor. Some pathological patterns of primary hepatic sarcoma, such as lipo
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第8期541-545,共5页
National Medical Journal of China
