摘要
目的：总结肝脏上皮样血管内皮细胞瘤（EHE）的影像学检查特征。方法：回顾性分析2007年3月至2014年6月收治的6例（其中烟台市烟台山医院3例、漳州市中医院2例、章丘市中医院 1例）肝脏EHE患者的临床资料。患者行CT和MRI平扫及动态增强扫描，观察病灶数目、形态、大小、部位、密度或信号、强化程度及方式等特征。采用门诊影像学检查进行随访，观察患者病灶变化情况，随访时间截至2014年6月。结果：6例患者中1例为单发病灶，5例为多发病灶。6例患者共检出125枚病灶，其中1例检出75枚。病灶多呈圆形或类圆形，融合病灶最大径为0.5～3.5 cm。病变发生部位以肝右叶和肝被膜下多见。6例患者病灶CT检查平扫均呈低密度，边界较清晰。4例患者病灶MRI检查平扫T1WI呈低信号，T2WI呈高信号或略高信号，均匀或不均匀。2例患者病灶呈肝脏“包膜回缩征”。6例患者行CT检查动态增强扫描，4例行MRI检查动态增强扫描，1例呈环状强化，5例基本均匀强化；所有病灶表现为延迟强化。3例患者部分病灶内可见静脉血管进入或通过病灶，血管腔正常或变窄。1例呈“棒棒糖征”。6例患者中，5例影像学检查诊断为肝转移癌，1例考虑肝胆管细胞癌。6例患者行肝脏肿瘤穿刺活组织检查，病理学检查结果示肝脏EHE。2例肝脏EHE患者确诊后未行任何抗肿瘤治疗，其中1例初诊后2年行CT检查示肝脏呈“包膜回缩征”，初诊后4年行MRI检查示继发性肝硬化，另1例初诊后6年半复查CT示肝硬化。1例手术治疗患者术后4年复查CT示肝左叶肿瘤复发，随访1年半年肿瘤无明显增大，后行超声引导下RFA治疗，随访半年无异常。另3例手术治疗患者术后分别随访1、4、5年均无复发、转移。结论：肝内单发或多发结节，CT和MRI检查动态增强扫描呈延迟强化是肝脏EHE的典型影像学表现，�
Objective：To summarize the imaging characteristics of the hepatic epithelioid hemangioendothelioma （EHE）. Methods：The clinical data of 6 patients with hepatic EHE who were admitted to the Yantaishan Hospital （3 patients）, Zhangzhou Hospital of Traditional Chinese Medicine （2 patients） and Zhangqiu Hospital of Traditional Chinese Medicine （1 patient） between March 2007 and June 2014 were retrospectively analyzed. All the patients underwent plain scan and dynamic enhanced scan of computed tomography （CT）, and the number, shape, size, location, density or signal, level and method of enhancement of the lesions were observed and analyzed. Six patients were followed up by outpatient imaging examination up to June 2014, and the changes of lesions were observed. Results：Among the 6 patients, 1 solitary lesion and 5 multiple lesions were detected, and the total lesions were 125 including 1 patient with 75 lesions. The lesions were round or roundlike and originated commonly from the right lobe of liver and hepatic subcapsular with a maximum diameter of 0.5-3.5 cm. Plain scan of CT showed that the lesions in 6 patients had low density with the clear boundary. MRI showed that low T1WI signal and high or slightly high T2WI signal of the lesions were detected in 4 patients. Two patients had liver “capsular retraction” sign. The ringlike enhancement of 1 lesion and homogeneous enhancement of 5 lesions were found by dynamic enhanced scan of CT in 6 patients and enhanced scan of MRI in 4 patients. Enhanced signal in all the lesions was detected in the delayed phase. Veins into or through lesions were found in 3 lesions, with normal or narrowing vascular cavity. One patient had visible “lollipop” sign. Of the 6 patients, 5 were confirmed as with metastatic carcinoma of liver, and 1 was suggested as with cholangiocarcinoma. Six patients were diagnosed with hepatic EHE by pathological examination using hepatic biopsy technique. Among the 2 patients with hepatic EHE who didn′t receive antineoplasti
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2015年第10期870-874,共5页
Chinese Journal of Digestive Surgery
关键词
肝肿瘤
上皮样血管内皮瘤
体层摄影术
X线计算机
磁共振成像
Liver neoplasms
Epithelioid hemangioendothelioma
Tomography, X-ray computed
Magnetic resonance imaging
