目的:探讨肝硬化性血管瘤(HSH)和硬化性海绵状血管瘤(SCH)的CT和MRI表现。
方法:纳入12例HSH和36例SCH。分析了CT(9HSH和34SCH)和MRI(8HSH和10SCH)的影像学表现。定性图像分析包括位置,尺寸,形状,囊回缩,密度,钙化,T1加权图像(T1WI)和T2加权图像(T2WI)上的信号强度,存在扩散限制,表观扩散系数(ADC)图,病灶周围短暂的肝脏衰减差异,和动态增强模式。
结果:肝硬化患者的HSH(3/12)高于SCH(1/36)(P=0.043)。增强前的形态外观在HSH和SCH之间没有显着差异。此外,与HSH(25%)相比,SCH在海绵状血管瘤中具有更强的向心增强趋势(83.3%)(P<0.001)。由于更频繁的非典型增强功能,包含边缘状增强,没有增强,和外围异质增强,HSH的误诊率(75%)明显高于SCH的误诊率(16.7%)(P<0.001)。此外,HSH和SCH的ADC值均高于周围肝实质(P=0.009,P=0.002);两组间ADC值差异无统计学意义(P=0.613)。
结论:SCH表现出与典型血管瘤相同的向心增强特征。而HSH由于完全硬化而表现出非典型的增强特征。较高的ADC值可能有助于从恶性肿瘤中识别非典型HSH和SCH。
OBJECTIVE: To investigate and compare the CT and MRI features of hepatic sclerosed hemangioma (HSH) and sclerosing cavernous hemangioma (SCH).
METHODS: Twelve HSH cases and 36 SCH cases were included, the imaging findings on CT (9 HSH and 34 SCH) and MRI (8 HSH and 10 SCH) were analyzed. Qualitative image analysis included the location, size, shape, capsular retraction, density, calcification, signal intensity on T1-weighted image (T1WI) and T2-weighted image (T2WI), presence of diffusion restriction, apparent diffusion coefficient (ADC) map, transient hepatic attenuation difference around the lesion, and the dynamic enhancement patterns.
RESULTS: The presence of liver cirrhosis in patients with HSH (3/12) was higher than SCH (1/36) (P = 0.043). The morphology appearance before enhancement showed no significant difference between HSH and SCH. Moreover, SCH had a stronger trend of centripetal enhancement patterns of cavernous hemangiomas (83.3%) compared to HSH (25%) (P < 0.001). Due to more frequent atypical enhancement features, containing rim-like enhancement, no enhancement, and peripheral heterogeneous enhancement, the misdiagnosis rate of HSH (75%) was significantly higher than that of SCH (16.7%) (P < 0.001). Furthermore, the ADC values of HSH and SCH were both higher than that of the surrounding liver parenchyma (P = 0.009, P = 0.002); however, there was no significant difference in ADC values between themselves (P = 0.613).
CONCLUSIONS: SCH showed the same trend of centripetal enhancement characteristics as typical hemangioma, while HSH exhibited atypical enhancement features due to complete sclerosis. Higher ADC values might contribute to the identification of atypical HSH and SCH from malignancies.