肝血管瘤伴门腔动脉分流：基于 DSA、CT 和 MR 成像的患病率和病变特征。

Hepatic hemangioma with arterioportal shunt: Prevalence and lesion characteristics based on DSA, CT and MR imaging.

机构信息

Department of Radiology, Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Road, Wuhan, 430022, China.

出版信息

Eur J Radiol. 2019 Dec;121:108715. doi: 10.1016/j.ejrad.2019.108715. Epub 2019 Oct 17.

DOI:10.1016/j.ejrad.2019.108715

PMID:31677545

Abstract

PURPOSE

To evaluate the prevalence and lesion characteristics of hepatic hemangioma (HH) with arterioportal shunt (APS) based on digital subtraction angiography (DSA), computed tomography (CT) and magnetic resonance (MR) imaging.

METHOD

Ninety-eight consecutive patients with 189 HHs who underwent DSA, CT and/or MR imaging of the liver between January 2014 and December 2017 were included. The diagnosis of APS was established by DSA. APS was categorized as peripheral and central shunt based on imaging findings. The incidence and appearance of APS on DSA were compared with those on CT/MR images. Eleven possible lesion characteristics associated with APS were compared between HHs with and those without APS. Multiple logistic regression modeling was used to identify the independent lesion characteristics associated with APS.

RESULTS

APS was diagnosed in 103 (103/189, 54.5%) HHs on DSA, of which 96 lesions appeared as peripheral APS and 7 appeared as central. In contrast, APS was detected only in 57 HHs (57/103, 55.34%) on CT/MR imaging, of which 50 (50/96, 52.08%) appeared as peripheral APS while 7 (7/7, 100%) appeared as central. Lesion size (P <  .001), enhancement rapidity (P =  .031), and vascularization degree (P <  .001) were found to be significant independent imaging characteristics associated with APS.

CONCLUSIONS

APS can occur in HH with high frequency. DSA was superior to CT/MR imaging in detection of APS, particularly for the peripheral APS. Lesion size, enhancement rapidity and vascularization degree were associated with the presence of APS.

摘要

目的

基于数字减影血管造影（DSA）、计算机断层扫描（CT）和磁共振成像（MR）评估肝血管瘤（HH）伴动静脉分流（APS）的发生率和病变特征。

方法

本研究纳入了 2014 年 1 月至 2017 年 12 月期间连续 98 例接受 DSA、CT 和/或 MR 肝成像的 189 个 HH 患者。APS 的诊断通过 DSA 确定。根据影像学表现，APS 分为外周性和中央性分流。比较了 DSA 上 APS 的发生率和表现与 CT/MR 图像上的表现。比较了有和无 APS 的 HH 之间 11 种可能的病变特征。采用多因素逻辑回归模型确定与 APS 相关的独立病变特征。

结果

DSA 诊断 103 个（103/189，54.5%）HH 存在 APS，其中 96 个病灶表现为外周性 APS，7 个病灶表现为中央性 APS。相比之下，仅在 57 个（57/103，55.34%）HH 中 CT/MR 成像检测到 APS，其中 50 个（50/96，52.08%）表现为外周性 APS，7 个（7/7，100%）表现为中央性 APS。病变大小（P <.001）、增强迅速性（P =.031）和血管化程度（P <.001）是与 APS 相关的显著独立影像学特征。