原发性肝血管肉瘤的多层螺旋CT表现

Multi-slice CT diagnosis of primary hepatic angiosarcoma

目的:探讨原发性肝血管肉瘤(PHA)的CT表现。方法:回顾性分析经手术病理证实的5例PHA患者的临床及影像学资料。年龄34～58岁,均为男性。5例均行CT平扫及增强扫描。结果:5例中4例呈巨块为主型,1例弥漫结节型;4例位于肝右叶,1例肝左右叶均累及;2例有子灶。增强扫描动脉期示2例中心及周边呈结节样强化、部分间隔不强化区,2例无明显强化,1例仅中心斑点状强化;门脉期示4例周边结节状强化,1例片絮状强化向内充填,中间夹杂片状无强化区;延迟期示4例强化而中心充填趋势比较明显,1例仍表现为边缘结节状强化。5例坏死区均未见强化。结论:PHA的CT表现有一定特征性,但特异性低,仍需病理检查方能确诊。

Objective： To investigate the CT manifestations of primary hepatic angiosarcoma （PHA）. Methods： The clinical and CT materials of 5 patients with pathology proven primary hepatic angiosarcoma （PHA） were retrospectively analyzed. All of the 5 patients underwent spiral CT before and after contrast enhancement. Results：Of these 5 pateints,there were dominant huge mass （n=4） and diffuse nodules （n= 1）. Four of the lesions located at right hepatic lobe and one at both lobes;daughter loci could be assessed in 2 cases. In the arterial phase after enhancement, central and peripheral nodular enhancement with non-enhancement of part of the septa was found in 2 cases,no marked enhancement in 2 cases and central spotty enhancement in 1 case. In portal venous phase, peripheral nodular enhancement was showed in 4 cases, cotton-like en- hancement with filling-in accompanying with patchy non-enhancement in 1 case. During the delayed phase, the tendency of obvious filling in was showed in 4 cases, peripheral nodular enhancement in 1 case. The necrotic area in all 5 cases showed non-enhancement. Conclusion： Certain CT characteristics can be revealed in PHA, ye;t with low specificity, the final diagnosis depends on pathology.