Department of Radiology, Foshan Hospital of Traditional Chinese Medicine, Foshan, 528000, China.
Key Laboratory for Biorheological Science and Technology of Ministry of Education(Chongqing University), Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, 400044, China.
Clin Radiol. 2019 May;74(5):406.e1-406.e8. doi: 10.1016/j.crad.2018.12.013. Epub 2019 Jan 25.
To analyse the computed tomography (CT) and magnetic resonance imaging (MRI) manifestations of hepatic angiosarcoma.
Nineteen patients with hepatic angiosarcoma underwent preoperative abdominal unenhanced and contrast-enhanced CT (11 cases) or (eight cases) MRI.
The results of a coagulation examination showed varying degrees of abnormalities in 12 (63.16%) cases (most were prolonged prothrombin time and an increased proportion of prothrombin time), which were the most common abnormalities on the laboratory tests. Unenhanced CT of the lesions showed homogeneous or heterogeneous hypointense with hyperintense haemorrhagic lesions, contrast-enhanced CT was performed for six cases (6/11, 54.5%) with centripetal heterogeneous filling. All lesions showed heterogeneous intensity at MRI, including heterogeneous hypointense T1WI and homogeneous or heterogeneous hyperintense T2WI. Haemorrhage lesions showed higher hyperintensity with spot or patchy signals. Centripetal enhancement was found in six cases using contrast-enhanced imaging. Flaky patches of contrast enhancement were seen in the lesions.
The CT and MRI features of most of the hepatic angiosarcomas in the present study were relatively characteristic: the border of the mass was indistinct, the density was heterogeneous, and haemorrhage was frequently seen, with secondary calcification in a few cases, whereas enhanced imaging showed typical centripetal heterogeneous enhancement. In addition, highly malignant angiosarcoma could not be enhanced.
分析肝脏血管肉瘤的计算机断层扫描(CT)和磁共振成像(MRI)表现。
19 例肝脏血管肉瘤患者行术前腹部平扫及增强 CT(11 例)或 MRI(8 例)检查。
凝血检查结果显示 12 例(63.16%)存在不同程度的异常(最常见的是延长的凝血酶原时间和增加的凝血酶原时间比例),这是实验室检查中最常见的异常。病变的平扫 CT 表现为均匀或不均匀低信号伴高信号出血性病变,增强 CT 检查 6 例(6/11,54.5%)呈向心性不均匀填充。所有病变在 MRI 上均表现为不均匀强度,包括不均匀低信号 T1WI 和均匀或不均匀高信号 T2WI。出血性病变呈更高的高信号,呈斑点或斑片状信号。增强成像发现 6 例病变呈向心性增强。病变呈片状增强斑块。
本研究中大多数肝脏血管肉瘤的 CT 和 MRI 特征较为典型:肿块边界不清,密度不均匀,常伴有出血,少数病例伴有继发性钙化,增强扫描显示典型的向心性不均匀强化。此外,高度恶性的血管肉瘤可能不增强。