原发性肝血管肉瘤多层螺旋CT表现与病理对照分析

Comparative Analysis of MSCT Features and Pathological Characteritics of Primary Hepatic Angiosarcoma

目的分析原发性肝血管肉瘤(PHA)的多层螺旋CT(MSCT)表现,以提高对本病的认识。方法回顾性分析6例经病理证实的PHA的MSCT表现并复习相关文献,各例均行平扫及多期增强扫描,对病灶的部位、数目、大小、形态、边缘、密度及强化特征等进行观察分析。结果 6例PHA中,单发巨块型4例,混合型2例。6例CT平扫均呈低密度,均匀或不均匀;4例巨块型动脉期病灶边缘呈中度或明显不均匀环状或结节状强化,中心区见不规则条索状或斑片状明显强化;门脉期及延迟期呈持续强化,呈向心状和(或)离心状扩展,中心区均未完全填充。2例混合型为1枚较大主灶伴数目不等子灶,边界清晰,呈类圆形或分叶状。巨块主灶强化特点与单发巨块型相似,子灶增强后可无强化,也可呈向心性强化、均匀强化或中心强化。结论 PHA的MSCT表现具有一定特征性,结合临床病史及体征,应考虑到PHA的可能性,最终确诊还需依靠病理及免疫组织化学。

To explore the multislice spiral CT （MSCT）performence of primary hepatic angiosarcoma. Methods In this retrospective studies, 6 patients with pathologically confirmed primary hepatic angiosarcoma under went preoperative MSCT and lobectomy. To analyz the tumor location, number, size, contour, periphery, density, and contrast enhancement patten. Both plain and multi-phase enhanced CT examinations were performed in all the 6 patients. Results Among the 6 cases,solitary huge mass type was seen in four and mixed type in two. On plain CT scan,the PHA lesions appeared as heterogeneous or homogeneous hypodense area. 4 cases of massive type of arterial lesions were moderately or significantly uneven edges cyclic or nodular enhancement, the central area with irregular or patchy streak significantly enhanced; which remained in portal and delayed phase and the central area of the lesion was not completely filled with contrast. Two cases of mixed type dominant masses with multiple satellite nodules and the dominant mass demonstrated lobular or round in shape. Huge mass of dominant mass strengthening characteristics and single huge mass of similar type. The satellite lesions showed showed variable enhancement patterns, such as non- enhancement, homogoneous, focal,rim-enhancement or progressive opcification from periphery to center. Conclusion PHA have some characteristic MSCT features, however the diagnosis depends on clinical characters.The ultimate diagnosis relies on the pathological and immunohistochemical examination.