肝海綿狀血管瘤英文·精品課件

肝臟海綿狀血管瘤

CavernousHemangiomaofLiver

Outline

mostcommon

benign1%-20%indifferentplaceF〉M90%solitary

CavernousHemangiomaofLiverClinicalsymptomsMostofthemnevercause

symptomsorhealthproblems.andareincidentallydiscoveredatmedicalexamination,surgery,orautopsy(尸檢).rightupperabdominalpain、pain,nausea(惡心)、enlargementoftheliver；

Pathologicalappearance

Cavernoushemangiomaisresultedfromendothelialcellsproliferation（增殖）.

Thetumorconsistsinlarge(cavernous)spaces,linedbytumorendothelialcells，Theseinterconnectedspacesarefilledwithbloodandseparatedbyafibroustissue。

Oralcontraceptives（口服避孕藥）andsteroids(類固醇)may

acceleratethegrowthofahemangioma.Whetherornotthesedrugsactuallyinducetheformationofthehemangiomaisunclear.Causes+C20’’動脈期contrast-enhancedCTscanarterial

phaseThelesionappearsperipheralnodularenhancement（邊緣結(jié)節(jié)狀強化），thecenterofthelesiontypicallyremainshypodense.

+C5’延遲期

delayed

phase

The

wholelesionishomogeneousenhancement,thedensityis

higherorequaltothesurroundingnormalliver(sometumorshavelow-densitycenterwhichrepresentfibreorthrombus).

Diagnosis（MRI）T1WIT1WIsmooth,lobulated,homogeneous,sometimesseptatedhypointensemassrelativetotheliverNonenhancedMRIscansT2WImarkedlyhyperintensemass，

thesignalintensityofthelesionissimilartothatofthecerebrospinalfluid.‘lightbulb’sign燈泡征T2WIcontrast-enhancedMRIscan

Theseimagesdemonstratetheprogressive,centripetalcontrastenhancementinahemangioma.

早出晚歸快進(jìn)慢出o

hemangiomascandemonstrateimmediatehomogeneousenhancement(lesions<1.5cm)o

nodularcentripetalenhancementpatternprogressingtohomogeneity(lesions1.5-5cm)o

nodularcentripetalenhancementwithpersistentcentralhypointenseregion(lesions>5cm)

Differentialdiagnosis肝囊腫Hepaticcyst

原發(fā)性肝癌primaryhepaticcarcinoma

肝轉(zhuǎn)移瘤

hepaticmetastatictumornonenhancement‘bulley