肝上皮样血管内皮细胞瘤的影像学及病理特征（附16例）

目的:探讨肝上皮样血管内皮细胞瘤（hepatic epithelioid hemangioendothelioma，HEHE）的影像学和病理特征，以提高对HEHE诊断及鉴别能力。方法:回顾性分析经病理证实的16例HEHE患者的影像学和病理特征。结果:5例单发病灶，11例多发病灶。CT平扫病灶呈圆形及类圆形低密度，多发病灶常分布于肝右叶被膜下等特点。MR平扫病灶T2WI呈不均匀高信号影，T1WI呈不均匀低信号。CT、MR增强后均呈环形强化和渐进性向心强化特点。免疫组化表现为CD31阳性16例，CD34阳性15例，ERG阳性12例。结论:影像学对HEHE有一定的检查价值，影像表现具有一定特征性，可助于术前诊断，但术前鉴别诊断有一定困难，需要病理检查。

Imaging and pathological features of hepatic epithelioid hemangioendothelioma(16 cases)

Objective:To analyze the imaging and pathological features of hepatic epithelioid hemangioendothelioma (HEHE),in order to improve the ability of diagnosis and differential diagnosis of HEHE.Methods:A retrospective analysis was performed for computed tomography (CT),magnetic resonance (MR) images and pathological features of 16 patients who visit our hospital with pathologically confirmed HEHE.Results:There were 5 cases of single lesions.Multiple lesions were found in 11 cases.The lesions on CT plain scan showed low density and were mostly round or quasi-round.Multiple lesions were distributed under the right lobe of the liver capsule.MR plain T2 weighted image (T2WI) scan showed uneven high signal.T1 weighted image (T1WI) scan showed heterogeneous low signal.CT and MR enhancement scan showed the ring enhancement and progressive centripetal enhancement.Immunohistochemistry showed 16 cases were positive for CD31.15 cases were positive for CD34.12 cases were positive for ERG.Conclusion:CT and MR have a certain value in the examination of HEHE.The imaging features have certain characteristics,and can help the preoperative diagnosis,but preoperative differential diagnosis is difficult.The pathological examination is needed.