肝脏少见血管源性恶性肿瘤的CT表现

CT Features of Rare Hepatic Vascular-originated Tumors

目的分析肝脏少见血管源性恶性肿瘤的CT表现,以提高对此类疾病的认识。材料和方法回顾性分析4例经病理证实的肝脏少见血管源性恶性肿瘤的临床资料和CT图像。分析内容包括部位、大小、形态、数目、密度、周围情况及远处转移等。结果 4例中,肝脏血管肉瘤2例,上皮样血管内皮瘤2例。病灶多发,同时累及左右叶3例,直径0.9～15.0cm不等;病灶单发1例,大小约10.7×13.4cm。表现为圆形或类圆形3例,不规则形1例。病灶边界不清2例,边缘清楚2例。4例肿瘤平扫时均表现为稍低或低密度,其中2例肿瘤内部出现明显坏死灶,1例病灶内出现片状出血;动脉期2例病灶出现强化,强化明显区域位于病灶中心区;2例病灶边缘轻度强化,其中1例病灶中见点状血管影;静脉期2例病灶强化区域较动脉期增大,另2例强化程度较动脉期未见明显变化。1例肿瘤出现肺内多发转移灶和脾脏转移灶。结论肝脏少见血管源性肿瘤临床和影像学表现均缺乏特异性,易误诊为其他疾病,需不断积累经验以提高对本病的认识。

Objective To analyze the CT features of rare hepatic vascular-originated tumors, and to improve the realization to this kind of disease. Materials and Methods The clinical data and CT images of 4 cases with rare hepatic vascular-originated tumors confirmed by pathological were analyzed retrospectively, including location, size, shape, number, density. surrounding circumstances and distant metastasis. Results Of all the 4 cases, 2 cases were liver angiosarcoma, and 2 cases were epithelioid hemangioendothelioma. Multiple lesions displayed in 3 cases（the diameter ranging from 0.9 - 15.0cm） and single lesion in I case（ 10. 7 iA 13.4cm）.The tumor demonstrated as round or oval in 3 cases and irregular-shape in 1 case. There were ill-defined lesions in 2 cases and well-difined lesions in 2 cases. All cases showed low density. 2 cases showed significant necrosis, and 1 case showed foliated bleeding lesions. In the arterial phase, 2 cases showed enhancement in the central area of ？？ the lesion. 2 cases showed mild enhancement of the edge, and 1 case of them showed punctate shadow of vessels. During the venous phase, 2 cases showed larger enhanced region than that of the arterial phase and the other 2 cases showed no significant changes. 1 case showed pulmonary and splenic metastasis. Conclusion The clinical and imaging findings of rare hepatic vascular-originated tumors are not specific, so these diseases are often misdiagnosed as other diseases. It is nessisary to accumulate experiences and knowledge about this kind of diseases.