肝脏血管肉瘤CT及MRI影像表现

CT and MRI findings in four cases of hepatic angiosarcoma

目的 探讨肝脏血管肉瘤(HA)的CT及MRI影像表现。方法 回顾性分析解放军总医院第五医学中心经病理证实的4例肝脏血管肉瘤的CT及MRI的影像表现。结果 4例均为多发病灶,4例行MRI和CT检查,2例仅行CT检查,1例病灶见瘢痕及肝动脉穿行,4例患者病灶内均有出血,CT表现为不均匀低密度影,MRI表现为T1 WI呈低信号,T2 WI呈高信号,DWI呈混杂或稍高信号,ADC呈高信号,动态增强扫描4例患者动脉期病灶边缘或病灶内斑片状强化,随着时间的延长,病灶强化范围增大,即向心性或离心性强化。结论 HA的CT及MRI影像表现具有一定的影像特点。多发病灶ADC呈高信号、动态增强扫描向心型及离心性强化提示肝脏血管肉瘤。

Objective To investigate the specific manifestation of hepatic angiosarcoma under computer tomography(CT)and magnetic resonance imaging(MRI).Methods The CT and MRI features of four cases of hepatic angiosarcoma(HA)confirmed by pathology in the Fifth Medical Center of PLA General Hospital in Beijing were retrospectively analyzed.Results All 4 HA patients had multiple lesions.One patient had lesions with scar and hepatic artery crossing.All 4 patients had bleeding within the lesions,which was shown by CT as uneven low-density shadow in the lesions,and by MRI as low intensity signal on T1WI,high intensity signal on T2WI,mixed or slightly high intensity signal on DWI,and high signal on apparent diffusion coefficient(ADC).Dynamic enhanced scanning showed patchy enhancement at the edge or within the lesion at arterial stage in all patients.With time extension,the enhancement range of the lesion increased,namely centripetal or eccentric enhancement.Conclusion The CT and MRI findings of HA have certain imaging characteristics.Features of multiple lesions,internal bleeding,high signal on ADC,centripetal and eccentric enhancement on dynamic enhanced scan indicate hepatic angiosarcoma.