【摘要】 目的:探讨非典型肝海绵状血管瘤(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改变。结果:有13个病灶CT平扫呈非均匀密度。共出现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)动脉期肿瘤周边结节状强化,门静脉期及延迟期呈向心性强化,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,门静脉期及延迟期向周边呈离心性强化;Ⅳ型(1例)动脉期病灶无明显强化,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9个病灶周围可见动脉-门静脉分流(APVS),4个病灶邻近可见肝包膜回缩(HCR)征。以上非典型CT表现的出现在不同大小的病灶中差异有显著性意义(P<0.05)。结论:HCH非典型CT表现的出现与病变的结构特征密切相关,认识其非典型表现对HCH的诊断和鉴别诊断有重要意义。更多还原

【Abstract】 Objective:To study the CT features of atypical hepatic cavernous hemangioma (HCH) and correlated with pathologic findings.Methods:The CT manifestations including size,attenuation on non-enhanced CT,patterns of dynamic enhancement and appearances in adjacent regions were reviewed retrospectively in 18 cases (21 lesions) of atypical HCH.Results:Heterogeneous attenuation on non-enhanced CT were found in 13 lesions.There were 4 types of atypical patterns on dynamic enhanced CT.Type Ⅰ (n=5) was demonstrated as immediate homogeneous enhancement during arterial phase,and persistent enhancement in venous and delayed phases;type Ⅱ (n=13) showed peripheral and globular enhancement during arterial phase,and progressive centripetal enhancement but incomplete filling of the lesion during venous and delayed phases; type Ⅲ (n=2) revealed central enhancement at arterial phase,and progressive centrifugal enhancement during venous and delayed phases; type Ⅳ (n=1) appeared no enhancement during arterial phase,and slight peripheral or heterogeneous enhancement during venous and delayed phases.In the adjacent region of HCH,arterial-portal venous shunt (APVS) was found in 9 lesions and hepatic capsular retraction (HCR) in 4 lesions.There were significant difference of these atypical CT findings in different size of lesions.Conclusion:Atypical CT appearances of HCH were closely correlated with their pathologic characteristics.Understanding of these atypical CT appearances is important for the diagnosis and differential diagnosis of HCH.更多还原