肝上皮样血管内皮瘤的CT与MRI特征及病理基础

The CT and MRI Features of Hepatic Epithelioid Hemangioendothelioma with the Correlation of Pathology

目的:探讨肝上皮样血管内皮瘤(HEHE)的CT与MRI表现特征及病理基础。资料与方法:回顾性分析经手术治疗且病理证实的HEHE 10例患者资料。结果:10例均主要表现为肝内多发包膜下结节。8例出现"包膜皱缩征";6例出现"晕环征";2例出现"棒棒糖征";8例出现"瘤内血管征"。增强扫描8例表现为动脉期轻中度边缘强化;门脉期及延迟期进一步向心性强化;2例表现为动脉期边缘轻度强化,门脉期及延迟期未见明显变化。结论:肝脏多发包膜下结节,"包膜皱缩征"、"晕环征"、"棒棒糖征"、"瘤内血管征"等表现具有一定的特征性,尤其是"棒棒糖征"或"瘤内血管征"具有一定的特异性,有助于HEHE的诊断及鉴别诊断。

Purpose： To analyze the CT and MRI features of hepatic epithelioid hemangioendothelioma（HEHE） with the correlation of pathology. Materials and Methords： CT and MRI data of ten cases with HEHE comfirmed by surgery and pathology were retrospectively analyzed. Results the lesions of six cases were multiple and mostly located adjacent to the hepatic capsule, the ＂capsular retraction＂ sign was found in eight cases, the ＂halo＂ sign was found in six cases, the ＂lollipop＂ sign was found in two cases, the ＂tumor vessel＂sign was found in eight cases. After contrast administration, mild to moderate peripheral enhancement was assessed in arterial phase, and progressive enhancement in portal venous phase and delay phase in eight cases, mild peripheral enhancement was assessed in arterial phase, but no significant alteration in portal venous phase and delay phase in two cases. Conclusion： multiple nodules under liver capsule, the capsular retraction sign, the halo sign, the lollipop sign and the tumor vessel sign were characteristic imaging features of HEHE, the lollipop sign and the tumor vessel sign have specificity in the diagnosis and differential diagnosis.