Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Jpn J Radiol. 2010 Apr;28(3):235-8. doi: 10.1007/s11604-009-0407-3. Epub 2010 May 1.
We present a case of a sclerosed hemangioma (SH) of the liver that showed a high apparent diffusion coefficient (ADC) value. The patient was undergoing preoperative evaluation for a metastatic breast cancer lesion when a liver mass with a diameter of 3 cm was found. It was described as a heterogeneously hyperechoic mass on ultrasonography and as a well-defined, lobulated mass with early peripheral enhancement and internal heterogeneous enhancement in the delayed phase on computed tomography. The fat-suppressed T2-weighted images demonstrated a heterogeneously hyperintense mass, which showed an ADC value of 2.01 x 10(-3) mm(2)/s. Liver metastasis and cholangiocellular carcinoma could not be excluded based on the imaging findings. After surgery, a definite diagnosis of SH was obtained. Microscopically, many hyalinized portions with poor cellular and fibrous components were observed in the tumor, and this hyalinization accompanied with liquiform degeneration, which may have been one of the causes of the high ADC value. We discuss the diagnostic value of diffusion-weighted imaging for SH of the liver.
我们报告了 1 例肝脏硬化性血管瘤(SH),其表观扩散系数(ADC)值较高。该患者因转移性乳腺癌病变而行术前评估时,发现肝脏直径为 3cm 的肿块。超声表现为不均匀高回声肿块,CT 表现为边界清楚的分叶状肿块,早期外周强化,延迟期呈内部不均匀强化。脂肪抑制 T2 加权图像显示为不均匀高信号肿块,ADC 值为 2.01 x 10(-3) mm(2)/s。根据影像学表现不能排除肝转移和胆管细胞癌。术后,明确诊断为 SH。镜下观察到肿瘤内有许多玻璃样变部分,细胞和纤维成分较少,这种玻璃样变伴有液化变性,这可能是 ADC 值较高的原因之一。我们讨论了扩散加权成像对肝脏 SH 的诊断价值。