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肝血管瘤:常见及不常见表现以及如何改进鉴别诊断

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis.

作者信息

Caseiro-Alves Filipe, Brito Jorge, Araujo Antonio Eiras, Belo-Soares Pedro, Rodrigues Henrique, Cipriano Augusta, Sousa Daniel, Mathieu Didier

机构信息

Clínica Universitária de Imagiologia, Hospitais da Universidade de Coimbra, Praceta Mota Pinto, 3000-075 Coimbra, Portugal.

出版信息

Eur Radiol. 2007 Jun;17(6):1544-54. doi: 10.1007/s00330-006-0503-z. Epub 2007 Jan 27.

Abstract

Haemangiomas are common focal liver lesions, generally detected in the work-up of asymptomatic patients. From the pathological point of view, they can be classified as small (capillary) or large, with cavernous vascular spaces that may show thrombosis, calcifications and hyalinisation. The polymorphic imaging appearance of haemangiomas depends on their histological features and flow pattern. The widespread use of cross-sectional imaging has allowed an increased detection rate and a better characterisation of this benign tumour. Recent developments of ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) providing high spatial and temporal resolution, together with the use of new contrast agents and/or pulse sequences has broadened the spectrum of imaging findings, contributing to diagnostic refinement in difficult cases. The scope of the present article is to provide an overview of the range of appearances of haemangiomas, explored with recent cross-sectional imaging modalities, emphasising its atypical findings as explored by temporally resolved contrast-enhanced imaging.

摘要

肝血管瘤是常见的肝脏局灶性病变,通常在对无症状患者的检查中被发现。从病理学角度来看,它们可分为小型(毛细血管型)或大型,具有海绵状血管腔,可能出现血栓形成、钙化和玻璃样变。肝血管瘤多样的影像学表现取决于其组织学特征和血流模式。横断面成像的广泛应用提高了这种良性肿瘤的检出率并能更好地对其进行特征描述。超声(US)、计算机断层扫描(CT)和磁共振成像(MRI)的最新进展提供了高空间和时间分辨率,同时新型造影剂和/或脉冲序列的使用拓宽了影像学表现的范围,有助于疑难病例的诊断细化。本文的目的是概述肝血管瘤在近期横断面成像模式下的各种表现,重点强调时间分辨对比增强成像所发现的非典型表现。

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