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1、·734·臨床放射學(xué)雜志2014年第33卷第5期腹部放射學(xué)原發(fā)性肝血管肉瘤的CT和MRI表現(xiàn)張偉，王蘭榮，薛鵬，皇甫幼田，陳勇，楊文魁，馬秀華，楊學(xué)華【摘要】目的探討肝血管肉瘤(PHA)的cT和MRI影像特征，提高診斷準(zhǔn)確率。方法回顧性分析經(jīng)病理證實的10例肝血管肉瘤患者的臨床和影像檢查資料，各例均行平掃及多期增強(qiáng)掃描，其中5例僅行cT掃描，5例行cT和MRI兩種檢查。結(jié)果10例PHA中，單發(fā)巨塊型7例，多發(fā)結(jié)節(jié)型1例，混合型2例。4例巨塊型病灶T1wI見片狀高信號出血灶，3例巨塊型病灶MRT2WI見雜亂流空血管影。增強(qiáng)掃描8個(8／
2、12)巨塊型病灶動脈期周邊部呈中度至明顯不均勻環(huán)狀或不規(guī)則形強(qiáng)化，中心區(qū)見不規(guī)則索條狀或結(jié)節(jié)狀明顯強(qiáng)化影；門脈期及延遲期持續(xù)強(qiáng)化，呈向心狀和(或)離心狀擴(kuò)展，中心區(qū)均未完全填充。1例多發(fā)結(jié)節(jié)型病灶動脈期及門脈期中心見斑片狀輕中度強(qiáng)化，延遲期持續(xù)強(qiáng)化，部分病灶各期未見明顯強(qiáng)化。結(jié)論P(yáng)HA的cT和MRI表現(xiàn)具有一定特征性，增強(qiáng)掃描具有較高的診斷價值，典型表現(xiàn)為動脈期周邊部和中心區(qū)明顯強(qiáng)化，門脈期及延遲期持續(xù)填充式強(qiáng)化，但多不能完全充填?！娟P(guān)鍵詞】肝腫瘤血管肉瘤體層攝影術(shù)，x線計算機(jī)磁共振成像CTandMRIManifestationsof
3、PrimaryHepaticAngiosarcomasZHANGWei，WANGLanrong，XUEPeng，eta1．DepartmentofMedicalImaging，ZhengzhouPeople’sHospital，Zhenzhou，HenanProvince450003，P．R．China【Abstract】ObjectiveToinvestigateCTandMRIcharacteristicmanifestationsofprimaryhepaticangiosarcoma(PHA)inordertoimprovei
4、tsdiagnosticaccuracy．MethodsTheclinicalandimagingmaterialsof10patientswithpath—ologically-provedPHAwereretrospectivelyanalyzed．Bothplainandmulti-phaseenhancedCTexaminationswereperformedinallthe10patients．AdditionalMRIscanningwasemployedin5patients．ResultsAmongthe10cases
5、．solitaryhugemasstypewasseenin7，muhiplenoduletypeinoneandmixedtypeintwo．In4caseswithhugemasstype，patchyhighsignalonT1WI，indicatingbleeding，wasdemonstrated．Inotherthreecaseswithhugemasstype，disorderlyflow-voidvas—cularshadowonT2W1wasdetected．Onenhancedscans，eighthugelesi
6、onsshowedmoderatetomarkedperipheralinhomo—geneousring—likeorirregularenhancementatarterialphase．whichremainedinportalanddelayedphaseandthecentralar-eaofthelesionwasnotcompletelyfilledwithcontrast．Inonecasewithmuhiplenoduletypemildtomoderatepatchyen—hancementatcentralare
7、awasrevealedduringthearterialandportalphase，andtheenhancementwaskeptonindelayedphase．Somelesionsshowednoobviousenhancementinallphases．ConclusionPrimaryhepaticangiosarcomacarriescertainCTandMRIcharacteristicsfeatures．Enhancedscanningplaysanimportantroleinmakingdiagnosiso
8、fPHA．ThetypicalimagingmanifestationofPHAismoderatetomarkedenhancementattheperipheralandcentralareaofthetumordu
