经组织学证实的肝上皮样血管内皮瘤的超声造影检查
Contrast-enhanced ultrasound of histologically proven hepatic epithelioid hemangioendothelioma.
作者信息
Dong Yi, Wang Wen-Ping, Cantisani Vito, D'Onofrio Mirko, Ignee Andre, Mulazzani Lorenzo, Saftoiu Adrian, Sparchez Zeno, Sporea Ioan, Dietrich Christoph F
机构信息
Yi Dong, Wen-Ping Wang, Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
出版信息
World J Gastroenterol. 2016 May 21;22(19):4741-9. doi: 10.3748/wjg.v22.i19.4741.
AIM
To analyze contrast-enhanced ultrasound (CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma (HEHE) in comparison to other multilocular benign focal liver lesions (FLL).
METHODS
Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.
RESULTS
HEHE manifested as a single (n = 3) or multinodular (n = 22) FLL. On CEUS, HEHE showed rim-like (18/25, 72%) or heterogeneous hyperenhancement (7/25, 28%) in the arterial phase and hypoenhancement (25/25, 100%) in the portal venous and late phases (PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas (18/25, 72%); in seven patients (7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature (P < 0.01).
CONCLUSION
CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE.
目的
分析经组织学证实的肝上皮样血管内皮瘤（HEHE）与其他多房性良性肝脏局灶性病变（FLL）的超声造影（CEUS）特征。
方法
回顾性分析25例经组织学证实的HEHE患者和45例经组织学证实的多房性良性FLL患者。四名放射科医生共同评估CEUS增强模式。
结果
HEHE表现为单发（n = 3）或多发结节（n = 22）性FLL。在CEUS上，HEHE在动脉期表现为边缘样（18/25，72%）或不均匀高增强（7/25，28%），在门静脉期和延迟期（PVLP）表现为低增强（25/25，100%），这是恶性肿瘤的征象。18例患者显示中央无增强区（18/25，72%）；7例患者（7/25，28%）在PVLP期检测到更多病变。相比之下，所有血管瘤和局灶性结节性增生患者均表现为高增强，这是最显著的特征（P < 0.01）。
结论
CEUS有助于明确FLL的特征。通过分析PVLP期的低增强，CEUS可以确定HEHE的恶性性质。
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