肝脏原发性血管肉瘤的CT表现(附3例报告及文献复习)

CT Findings of Primary Hepatic Angiosarcoma(Report of 3 Cases and Literature Review)

目的探讨肝脏原发性血管肉瘤的CT诊断特点及鉴别诊断。资料与方法对经手术病理证实的3例肝脏原发性血管肉瘤的CT表现进行回顾性分析,并结合文献分析肝脏原发性血管肉瘤的CT表现特点。结果 2例表现为巨块型,并周缘见子病灶,1例表现为弥漫多结节型,平扫均表现为不规则低密度区,无明显边界,增强扫描动脉期病灶内呈轻度不均匀强化,门静脉期可见不规则条状及斑片状强化,延迟期病灶呈向中心充填式强化;肝内外胆管均未见扩张,1例伴双肺转移瘤。结论肝脏原发性血管肉瘤的CT表现具有一定特点,结合临床病史及体征,不难与肝血管瘤、肝癌及肝转移癌鉴别。

Objective To discuss the CT features of primary hepatic angiosarcoma.Materials and Methods Three cases of primary hepatic angiosarcoma confirmed by pathologicalresults were retrospectively analyed and correlative literaturea were reviewed.Results Two cases showed huge masses with surrounding little nodules.One case showed diffused multiple nodules.The tumors showed irregular low density area without clear boundary on plain CT,mild heterogenous enhanced at arterial phase irregular patchy enhanced at portal vessel phase and filled-in enhanced at delayed ohase.Hepatic duct had no dilation in all cases.One case had lung metastatic lesion.Conclusion CT features combined with clinical history can help to differentiate primary hepatic angiosarcoma from hepatic cancer and metastatic tumor. 【Key