原发性肝脏恶性纤维组织细胞瘤的CT诊断及鉴别

CT diagnonsis ang differrential diagnonsis of permary hepatic malignant fibrous histiocytoma

目的:探讨原发性肝脏恶性纤维组织细胞瘤的CT诊断及鉴别诊断。方法:回顾性分析5例经手术或活检病理证实的原发性肝脏恶性纤维组织细胞瘤的CT表现。结果:3例肿瘤位于肝右叶,2例位于肝左叶,4例肿瘤边界清楚,1例与周围肝实质分界不清。CT平扫5例肿瘤均表现为不均匀低密度,增强扫描肿瘤强化方式多样,5例肿瘤中,3例车辐状多形性型肝MFH增强扫描动脉期肿瘤实性成分轻中度不均匀强化,另外2例炎症型肝MFH动脉期明显强化,门脉期进一步强化,延迟扫描5例肿瘤均呈低密度,但肿瘤内部实性成分显示更为清晰。5例肿瘤中有4例可见粗大的供血动脉进入肿块内部。结论:肝脏恶性纤维组织细胞瘤CT表现多样,掌握不同病理类型肝MFH的CT表现,可提高其诊断的准确性。

Objective：To investigate the CT diagnosis and the diferential diagnosis of primary hepatic malignant fibrous histiocytoma. Methods：The features of CT findings in 5 cases of primary hepatic malignant fibrous histiocytoma by suygery and biopsy were analyzed retrospectively. Results： 3 tumors were located in the right lobe of the liver, 2 tumors were located in the left lobe of the liver. The marginal contours of 4 tumors were regular, the other was irregular. CT plain scanning revealed that all tumors were uneven hypodense. The features of MFH after enhancement were various. In the five cases, storiform-pleomorphic type of malignant fibrous histiocytoma （n= 3） was showed mild to moderate enhancement, while xanthomatous type of malignant fibrous histiocytoma was enhanced obviously, and further strengthened at venous phase. All the tumors of the five cases presented low density and much clearer border at lag period. Large arteries which supplyed the tumor can be observed in four cases, Conclusion ： There are variety of CT manifestations of MFH in liver. Mastering the characteristic CT manifestations of MFH of different pathological types can elevate the accuracy of diagnosis.