肝脏血管周上皮样细胞瘤的CT多期扫描诊断价值

目的:探讨肝脏血管周上皮样细胞瘤的多排螺旋CT多期增强扫描特征。方法:回顾性分析7例经手术病理证实为肝脏血管周上皮样细胞瘤患者的临床及CT资料。其中3例行CT平扫、双期增强扫描及延迟扫描,3例行CT平扫、双期增强扫描,1例行CT平扫及单期增强扫描。结果:7例中6例为女性,2例为多发,5例为单发,且均位于肝右叶。CT平扫示肿瘤呈等密度-低密度,边界光整,圆形或类圆形,大小3～35cm;增强扫描动脉期6例病灶呈明显或较明显不均匀强化,1例呈不均匀轻度强化,3例动脉期见粗大血管位于肿瘤边缘或中心,强化方式为快进快出或快进慢出、持续性强化,延迟扫描呈低密度。其中3例含有大量脂肪成分,2例含有少量脂肪成分,2例无明显脂肪成分。结论:多排螺旋CT多期扫描表现结合临床资料对正确诊断肝脏血管周上皮样细胞瘤有重要价值,延迟扫描对本病与肝癌鉴别有很大价值。

Evaluation of multi-phase scanning in diagnosing perivascular epithelioid cell tumor of liver by multi-slice CT

Objective：To investigate the multi-slice CT（MSCT） features of perivascular epithelioid cell tumor（PEComa） by multi-phase scanning.Methods：Clinical and CT data of 7 cases with PEComa from December 2007 to March 2011 proved by pathology were analysed retrospectively.Plain CT scanning,arterial phase plus portal venous phase（2-phase） and delayed phase scanning were applied in 3 cases;Plain scanning and 2-phase scanning were used in 3 cases,plain scanning and portal venous phase scanning was applied in 1 case.CT features including shape,attunation and enhacement pattern of all these cases were analysed and correlated with pathology data.Results：There were six female patients and one male patient in the seven cases,among which,two cases were solitary and the others were multiple lesions.All the tumors were found in the right lobe of the liver.On plain CT scanning,all neoplasms were in round or round-like shape with low-or iso-densities,well-defined margins and 3~35cm in diameters.On arterial phase scanning,obviously inhomogeneous enhancement were found in all lesions with enlarged malformated vessels located in the center of or around the tumors in three cases.Not only quick-in and quick-out,but also quick-in and slow-out enhanced modes were shown in the seven cases.Low density on delayed phase were shown in all cases.Large amount of adipose tissue was detected in 3 cases,small amount in 2 cases,nearly no adipose tissue in 2 cases.Conclusion：CT feauteres of PEComa demontrasted by muti-phase scanning in combination with clinical data are important in making a correct diagnosis preoperatively,and delayed CT scanning plays a key role in differentiating PEComa from primary hepatocellular carcinoma.