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目的 探讨肝脏上皮样血管内皮细胞瘤（hepatic epithelioid haemangioendothelioma, HEHE）的核磁共振成像（magnetic resonance imaging, MRI）影像学特征。方法 回顾性分析2011年10月至2025年1月解放军总医院第五医学中心和新疆军区总医院派驻门诊部收治的15例经肝穿病理检查确诊为初治HEHE患者的MRI影像资料，总结其MRI影像学表现特征。结果 15例患者共检出157个病灶，其中12处病灶出现融合，4例（26.67%）伴有肝包膜皱缩；4例（26.67%）发生肺部转移。MRI表现为多层环状结构（层环结构），以T2WI及延迟期显示最为清晰，其中以2层及3层层环结构病灶最为常见；最多层数为4层，仅见于1例患者。所有病灶在DWI序列均表现为双层结构：外周呈高信号，中心呈稍高信号。绝大部分病灶中均可见血管穿行（血管穿行征），其中穿行血管为门静脉分支者133灶（84.71%），肝静脉分支者15灶（9.55%），肝动脉分支者6灶（3.82%）。4例有肝静脉分支血管穿行病灶的患者均发生了肺转移。结论 HEHE的MRI影像主要表现为层环结构与血管穿行征，这些特征可能对HEHE的临床诊治具有重要参考价值。
Abstract：Objective To explore the magnetic resonance imaging(MRI) features of hepatic epithelioid hemangioendothelioma(HEHE). Methods A retrospective analysis was conducted on the MRI data of 15 treatmentna?ve patients with pathologically confirmed HEHE. These patients were from the Fifth Medical Center of the PLA General Hospital and the outpatient department dispatched by the Xinjiang Military Region General Hospital from October 2011 to January 2025. The MRI characteristics of the lesions were evaluated. Results A total of 157 lesions were identified among the 15 patients. Fusion of lesions was observed in 12 cases, and hepatic capsular retraction was present in 4 patients(26.67%). Lung metastases occurred in 4 patients(26.67%). MRI revealed a multi-layer ring appearance, which was most clearly demonstrated on T2-weighted images(T2WI) and delayed-phase images. Two-and three-layer structures were the most common, while a fourlayer structure was observed in only one patient. On diffusion-weighted imaging(DWI), all lesions exhibited a double-layer appearance: hyperintense in the peripheral and slightly hyperintense in the center. Blood vessel penetration was observed in most lesions, including 133(84.71%) portal vein branches, 15(9.55%) hepatic vein branches, and 6(3.82%) hepatic artery branches.Notably, all four patients with hepatic vein branch penetration developed lung metastases. Conclusion The multi-layer ring appearance and vascular penetration sign are two characteristic MRI features of HEHE, which may have significant implications for the clinical diagnosis and treatment.
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基本信息:
中图分类号:R735.7;R445.2
引用信息:
[1]刘娜,樊文萍,刘佳,等.肝脏上皮样血管内皮细胞瘤MRI影像特征分析[J].传染病信息,2025,38(06):544-549+556.
2025-12-25
2025-12-25