肝脏转移性平滑肌肉瘤的CT表现

目的 分析肝脏转移性平滑肌肉瘤（metastatic liver leiomyosarcoma,MLL)的CT特点，以提高对MLL的认识。资料与方法 回顾性分析8例经手术证实的MLL的CT表现及临床特征，并复习文献。CT扫描包括平扫、动脉期、门脉期及延迟期三期增强扫描。结果 MLL平扫密度较低。较小的MLL增强后动脉期周边明显强化，中央液化坏死无强化。较大的MLL可以表现为囊性、囊实性、实性，肿瘤实质强化明显，血供丰富，血管造影证实了这一点。可有淋巴结及腹腔种植、转移。MLL易复发。结论 在肝脏占位的定性诊断中，结合原发病史、无特殊肿瘤标志物、特别是CT表现特点，应考虑到MLL的可能。

CT Manifestations of Metastatic Liver Leiomyosarcoma

Objective To analyze CT features of metastatic liver leiomyosarcoma (MLL), and to improve the diagnostic accuracy of MLL.Materials and Methods CT findings and clinical characteristics of 8 patients with surgically proved MLL were retrospectively analyzed. Plain and enhanced tri phase (including arterial, portal and delayed phase) scanning were performed.Results On plain scan, hypodense lesion was a common presentation of MLL. During arterial phase, the smaller lesions showed marked peripheral enhancement and central necrosis. The larger MLL presented as cystic, solid or mixed lesions, and the lesions were rich in vasculature, which was proved by angiography. Metastatic lymphadenopathy and abdominal implant were not uncommon. MLL was likely to recur. Conclusion MLL should be considered in the patients with known extra hepatic leiomyosarcoma who have space occupying lesions in the liver when special signs are demonstrated on CT scans and no tumor marker expressions can be tested.