肝脏血管周上皮样细胞瘤的CT表现(附4例报道及文献复习)

CT features of perivascular epithelioid cell tumor:A literature review of 4 cases

目的:分析肝脏血管周上皮样细胞瘤的CT特征,加深对该病的认识,以提高诊断准确率。方法:回顾性分析4例经手术病理证实的肝脏血管周上皮样细胞瘤的临床影像资料并文献回顾。2例患者均行腹部CT平扫和增强扫描,2例仅行CT增强。结果:本组4例均为女性,年龄39~57岁,平均46岁,2例位于肝左叶,2例发生于肝右叶。CT平扫呈低密度,类圆形,边界清楚或模糊,大小3.5~13 cm;增强扫描动脉期3例呈明显不均匀强化,1例呈边缘强化。4例动脉期均可见粗大迂曲血管位于肿瘤边缘。强化方式为快进快出、快进慢出或持续性明显强化。2例含有脂肪成分,2例无明显脂肪成分。结论:肝脏PEComa的CT表现具有一定特征性,对临床诊断该疾病有重要价值。

Objective： To analyze CT manifestation of perivascular epithelioid cell tumor（ PEComa） and improve the diagnostic accuracy. Methods： Clinical and CT data of 4 cases with PEComa proved by pathology were analysed retrospectively. Two cases performed both plain CT and contrast-enhanced CT,and two cases only used contrast-enhanced CT. Results： There were 4 women,and the age ranged from 39 to 57 years old along with the average age of 46 years old. All of the tumors,2 cases were found in the right lobe of the liver,2 cases were in the left. On plain CT scanning,all neoplasms were in round-like shape with low densities,well-defined margins or not and 3. 5 - 13 cm in diameters. On arterial phase scanning,obviously in homogeneous enhancement 3 cases were found,and peripheral enhancement in 1 case. Enlarged malformated vessels located in the center of or around the tumors were seen in all cases. Quick-in and quick-out,quick-in and slow-out enhanced modes were shown in the 4 cases. Adipose tissue was detected in 2 cases while nearly no adipose tissue in 2 cases. Conclusion： CT features of PEComa have a characteristic performance,which are important in making a correct diagnosis preoperatively.