肝脏血管周上皮样细胞瘤的CT、MRI表现和病理对照分析

Correlation analysis of CT and MRI findings and pathological features of hepatic perivascular epithelioid cell tumor

目的探讨肝脏血管周上皮样细胞瘤(PEComa)患者的CT、MRI影像特征,对照病理分析,以提高对该病诊断的准确性。方法选取经病理证实为肝脏PEComa的8例患者的影像学资料,分析病灶形态及其内部影像学特征及强化特点,与病理对照分析并复习相关文献。结果8例(100%)肝脏PEComa均为单发,7例(87.5%)边缘清晰,大小平均为4.5cm,4例(50.0%)病变内部不均匀;影像学检查4例(50.0%)见脂肪成分,其中2例(25.0%)含有大量脂肪成分,5例(62.5%)可见血管畸形,8例(100%)均未见出血、坏死及钙化;增强扫描4例(50.0%)为“快进快出”,2例(25.0%)为“快进慢出”,2例(25.0%)为“持续强化”。结论肝脏PEComa女性多见,多数单发,CT、MRI影像学表现为边界清晰,病变内部不均匀,可含有脂肪及畸形血管,强化方式多样。

Objective To investigate the CT and MRI findings and pathological features of hepatic perivascular epithelioid cell tumor(PEComa)so as to improve diagnostic accuracy.Methods The imaging data of 8 cases confirmed as hepatic PEComa were analyzed retrospectively,including the lesion morphology and its internal imaging features and contrast enhancement characteristics.And then,a correlation analysis with pathology and review of relevant literatures were conducted.Results A total of 8 cases(100%)with hepatic PEComa had single lesions,of which 7 cases(87.5%)had well-defined margins,with an average of 4.5cm in size,and 4 cases(50.0%)had Internal heterogeneity,and fat components were shown in 4 cases(50.0%).Among them,2 cases(25.0%)contained a lot of fat,5 cases(62.5%)showed vascular malformation,and bleeding,necrosis or calcification was not shown in all of 8 cases(100%).The enhancement pattern was"rapid-filling and rapidwashout"in 4 cases(50.0%),"rapid-filling and slow-washout"in 2 cases(25.0%)and"continuous enhancement"in 2 cases(25.0%),respectively.Conclusion Hepatic PEComa is common in women,and most of them have single lesion.CT and MRI images show well-defined margins,internal heterogeneity,or fat-containing and malformed blood vessels,and various enhancement pattern.