摘要
目的探讨肝血管周上皮细胞瘤的多种影像表现,以提高对该病的诊断水平。方法回顾分析经手术病理证实的11例肝血管周上皮细胞瘤的多种影像表现,所有患者术前均行CT和MRI检查后再行PET/CT检查,病例资料完整。结果 11例患者均为肝脏单发病灶,10例病灶位于肝右叶,1例位于肝左叶,病灶为圆形或类圆形,最大者直径约13.5 cm,最小者直径约1.8 cm,平均5.7 cm。CT平扫示肝内圆形或类圆形稍低密度影,边界清楚,较小病灶密度均匀,较大病灶密度不均匀,其内可见更低密度区;增强扫描动脉期病灶周边明显强化,门脉期病灶呈向心性不均匀强化,较大病灶内可见分隔,延迟期病灶强化明显减退呈等或稍低密度影。MRI平扫示病灶T1WI呈中等信号或稍低信号,较大病灶信号不均匀,病灶T2WI呈稍高信号,DWI病灶呈高信号,增强特征与CT类似。PET/CT检查所见,直径>3.0 cm病灶均可见放射性摄取异常浓聚或不均匀浓聚,SUV值最大为12.2,最小为3.6,平均值为5.7;直径<3.0 cm病灶表现为放射性摄取轻度浓聚,SUV值最高为4.7,平均为2.9;仅1例直径约1.8 cm的病灶表现为无明显放射性浓聚,与正常肝组织放射性摄取相同;延迟1 hPET/CT显像示,所有病灶的SUV值均不同程度降低。结论肝血管周上皮细胞瘤PET/CT显像检查具有特征性,与常规影像检查相结合,可以明显提高诊断水平。
Objective To investigate the imaging features of perivascular epithelioid cell tumor of liver （PEComa） , and to improve the diagnostic level of the disease. Methods A retrospective analysis of imaging manifestations was performed on 11 cases of hepatic hemangioma confirmed by surgery and pathology. All patients underwent CT and MRI examination before PET/CT examination, then received operation. Results Eleven cases were solitary hepatic lesions, 10 of which were located in the right lobe of the liver, and 1 in the left. The lesions were round or quasi-circular and the diameter ranged from about 13.Sere to about 1.8 cm, with an average of 5.7 cm. CT plain scanning showed that the liver was slightly lower density, with clear boundary. The smaller lesions were homogeneous density, while the larger ones were not, and the lower density area was visible. Enhancement of peripheral lesions in the arterial phase was enhanced. The lesions in the portal vein were not uniformly enhanced, and visible separation was found in large lesions. In the delay phase, the lesions were significantly decreased or slightly lower. MRI plain scan showed the lesion T1WI showed moderate signal or slightly low signal, and large lesion signal was not uniform, and T2WI lesions showed slightly high signal while DWI lesions high signal and the enhanced features were similar to those of CT. PET/CT examination showed that visible radioactive uptake of abnormal concentration or uneven concentration were found in lesions with diameter larger than 3.0 cm, and the maximum SUV value ranged from 12.2 to 3.6, with an average value of 5.7. Lesions with diameter less than 3.0 cm showed a slight concentration of radioactive uptake and the highest SUV value was 4.7, with an average value of 2.9. The only 1 1.8 cm lesion showed no significant radioactivity, which was as the same as that of normal liver tissue. Delayed PET/CT imaging （ 1 hour） showed that SUV values of all lesions were decreased in varying degrees. Conclusion PET/CT imaging of perivascular epithelioid cell tumor of liver has its characteristics. The combination of PET/CT imaging and routine imaging examination will benefit the improvement of diagnosis level obviously.
出处
《实用医学杂志》
CAS
北大核心
2017年第13期2221-2225,共5页
The Journal of Practical Medicine
