摘要
目的探讨非典型肝海绵状血管瘤(hepatic cavernous hemangiomas,HCH)的CT表现及相关病理学基础。方法回顾性分析18例共21个非典型HCH的CT表现,包括病灶大小、平扫密度、动态增强模式及邻近区域改变。结果平扫有13个病灶呈非均匀密度表现。出现4种非典型动态增强模式:Ⅰ型(5例)表现为动脉期病灶快速均匀强化,门静脉期及延迟期持续强化;Ⅱ型(13例)动脉期周边结节状强化,门静脉及延迟期向心性强化,但不能完全填充整个病灶;Ⅲ型(2例)动脉期病灶呈中央强化,门静脉期及延迟期增强向周边区呈离心性强化;Ⅳ型(1例)动脉期无明显强化,门静脉期及延迟期呈轻度周边强化或不规则强化。HCH邻近区域的改变:有7个病灶可见动脉-门静脉分流(arterial-portal verous shunt,APVS),4个病灶可见肝包膜回缩(hepatic capsular retraction,HCR)。以上非典型CT表现的出现在不同大小的病灶中有差别。结论非典型肝海绵状血管瘤CT表现的出现与HCH本身的病变结构特征密切相关,认识到这些非典型表现对HCH的诊断和鉴别诊断有重要意义。
Objective To approach the imaging features of hepatic cavernous hemangiomas （ HCH ） on CT and the correlation of these features with pathologic findings. Methods The CT manifestations including size of lesions, attenuation on nonenhanced CT scan, patterns on dynamically enhanced CT scans and in adjacent regions were reviewed retrospectively in 18 cases with 21 lesions. Results Heterogeneous attenuation on nonenhanced CT scan was found in 13 lesions. There were 4 types of atypical patterns on dynamic enhanced CT：type 1 （ n = 5） showing immediate homogeneous enhancement during arterial phase, and persistent enhancement in venous and delayed phases;type 2（ n = 13） appearing peripheral and globular enhancement during arterial phase,and progressive centripetal enhancement but incomplete filling of the lesion during venous and delayed phases;type 3（ n = 2） revealing central enhancement at arterial phase, and progressive centrifugal enhancement during venous and delayed phases; type 4（ n = 1 ） demonstrating no ment during venous and delayed enhancement during arterial phase, and slight peripheral or heterogeneous enhance- phases To appearences in contiguous regions, arterial- portal verous shunt （ APVS ） was found in 7 lesions and hepatic capsular retraction（ HCR） in 4 lesions. There were significant difference of these atypical CT related with findings in different size of lesions. Conclusion Atypical CT appearances of HCH were closely cortheir pathologic characteristics. Understanding of these atypical appearances is very important for the diagnosis and differential diagnosis of HCH.
出处
《南华大学学报（医学版）》
2006年第1期72-75,134,共5页
Journal of Nanhua University(Medical Edition)
