ISSN 1004-4140
CN 11-3017/P

婴儿型肝脏血管内皮瘤CT分型及相关影像学表现

The Classification Diagnosis of CT and its Imaging Features in Infantile Hepatic Hemangioendothelioma

  • 摘要: 目的:总结婴儿型肝脏血管内皮瘤(IHH)CT表现,以期提高对该病的诊断水平。方法:收集9例经过手术病理证实和2例穿刺活检证实IHH的CT资料,所有的患者均行CT平扫及动脉期、门脉期双期增强扫描,6例加做延时扫描,对其进行分析,比较各型的CT表现。结果:11例IHH,肿块型6例,直径在5~10cm之间;结节型3例,直径<5cm;弥漫型2例。平扫各型肿瘤均呈类圆形低密度,肿块型密度不均匀,均见钙化,4例中央区见液化坏死区,1例中央区见出血灶;结节型密度不均匀,1例见钙化;弥漫型密度均匀。肿块型均有分叶,结节型、弥漫型无分叶。增强扫描动脉期:肿块型5例边缘呈花瓣样强化,1例呈结节样强化;结节型3例边缘呈花瓣样强化;弥漫型1例边缘呈花瓣样强化,1例呈环形强化;3例肿块型及1例结节型出现自边缘向中心呈粗条状强化影,强化程度与同层腹主动脉相近;门脉期、延迟期全部肿瘤持续向心性强化,4例肿块型中央坏死区未见强化;结节型、弥漫型全部为全瘤强化。结论:IHH总体表现为向心性强化及延迟强化,但各型的CT分型表现有一定差异。

     

    Abstract: Objective: to summarize the image features of Infantile Hepatic Hemangioendothelioma(IHH) base on Computed Tomography, in order to improve the diagnostic capacity. Methods: 11 cases of IHH which were confirmed by pathological examination were recruited to explore their CT features, All patients had undergone enhanced scan, and 6 received delayed scan. Results: 11 cases of IHH included massive type(6),(diameter, 5-10 cm); nodular type(3),(diameter,< 5 cm); diffuse type(2). In plain scan, all the cases show round low-density focus, massive type appear to be uneven density, with multiple calcifications, lower-density focus shows in central region in 4 cases, hemorrhagic focus shows in central region in 1 case. Nodular type appear to be uneven density, and calcifications is found in 1 case; diffuse type appear to be uniform density; massive type are lobulated, with clear border or unclear border; nodular type and diffuse type are lobeless, nodular type have unclear border, and diffuse type have clear border; in enhanced scan arterial phase, floral pattern of contrast enhancement are seen in massive type(5), nodular type(3), diffuse type(1), nodular of contrast enhancement is seen in massive type(1), Peripheral of contrast enhancement is seen in diffuse type(1), centripetal cord-like contrast enhancement were seen in massive type(3) and nodular type(1), the tumor enhancement was isodense relative to the abdominal aorta; all cases showed progressive enhancement in the portal venous phase and delayed phase, 4 cases of massive type show no enhancement in central region, enhancement of the entire tumor are found in all cases of nodular type and diffuse type. Conclusions: CT appearance of IHH mainly presented as centrality enhancement and delayed enhancement, but different kinds of which is characteristic.

     

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