Kis E, Verebély T, Várkonyi I, Kövi R, Machay T, Máttyus I
Semmelweis Orvostudományi Egyetem, I. Gyermekklinika, Budapest.
Orv Hetil. 1997 Aug 17;138(33):2061-4.
The hepatic hemangiomas of infancy are rare, benign vascular tumours, differentiated in their morphologic and clinical appearances. They may manifest either as asymptomatic liver masses, or with the potentially fatal complication of congestive heart failure. They can be large in infancy, act as arteriovenous fistulas and may result in massive arteriovenous shunt. Multiple imaging modalities have been employed in the diagnosis, including ultrasonography (US), computed tomography (CT), radionuclide studies, angiography, magnetic resonance (MR) imaging. Generally the US, Doppler and CT appearances of hepatic hemangiomas may be diagnostic. Biopsy in often needed for diagnosis, especially if classic signs and symptoms are lacking. The diagnostic possibilities and difficulties in three patients are discussed. Different US images were present in all three cases, with atypical CT appearance in one. Doppler signals were lacking in two cases. Sonographic appearance of infantile hepatic hemangioma is variable, non-specific, but Doppler US is useful as a non-invasive method in the follow-up of hemangiomas.
婴儿期肝血管瘤是罕见的良性血管肿瘤，在形态学和临床表现上有所不同。它们可能表现为无症状的肝脏肿块，或伴有潜在致命的充血性心力衰竭并发症。它们在婴儿期可能很大，可作为动静脉瘘，可能导致大量动静脉分流。多种成像方式已用于诊断，包括超声检查（US）、计算机断层扫描（CT）、放射性核素研究、血管造影、磁共振（MR）成像。一般来说，肝血管瘤的US、多普勒和CT表现可能具有诊断意义。诊断通常需要活检，特别是在缺乏典型体征和症状的情况下。讨论了三名患者的诊断可能性和困难。所有三例均出现不同的US图像，其中一例CT表现不典型。两例缺乏多普勒信号。婴儿期肝血管瘤的超声表现多变、不具特异性，但多普勒超声作为一种非侵入性方法在血管瘤随访中很有用。
