席清 1齐雪幸 1荣雪飞 1孙沛 1李惠贞 1高远2
作者信息
- 1. 中国人民解放军总医院第五医学中心放射诊断科,北京 100039
- 2. 航天中心医院肝胆外科,北京 100049
- 折叠
摘要
Abstract
Objective To investigate the multimodal imaging features of hepatic epithelioid hemangioendothelioma(HEHE)and analyze its characteristic signs,aiming to improve the preoperative diagnostic accuracy of this rare tumor.Methods A retrospective analysis was performed on the clinical,imaging and pathological data of 19 patients with pathologically confirmed HEHE enrolled from the Fifth Medical Center of Chinese PLA General Hospital between January 2013 and December 2024.Imaging evaluation included lesion distribution,signal characteristics on magnetic resonance imaging(MRI),dynamic contrast-enhancement patterns,specific imaging features,and metabolic characteristics on positron emission tomography-computed tomography(PET/CT),as well as preoperative imaging diagnosis results.All imaging findings were correlated with pathological results.Results Among the 19 HEHE patients,1(5.3%)presented with a solitary lesion,14(73.7%)with multiple lesions,and 4(21.1%)with diffuse lesions.Contrast-enhanced MRI revealed no enhancement in 4 cases(21.1%),heterogeneous enhancement in 7(36.8%),and rim enhancement in 8(42.1%)during the arterial phase(AP).Centripetal progressive enhancement during the portal venous phase(PVP)and delayed phase(DP)was observed in 8 cases(42.1%).The"lollipop sign"was present in 8 cases(42.1%),and the"hepatic capsular retraction sign"in 7(36.8%).Of the 8 patients who underwent PET/CT,7 showed mild-to-moderate 18F-fluorodeoxyglucose(18F-FDG)uptake,1 case showed no significant 18F-FDG uptake in right hepatic lobe lesions,and extrahepatic metastases were detected in 5 cases.Only 2 of the 19 patients were correctly diagnosed preoperatively by MRI,yielding a misdiagnosis rate of 89.5%,with HEHE was most frequently misdiagnosed as hepatocellular carcinoma(HCC)or hepatic metastases.During follow-up,spontaneous tumor regression was observed in 3 conservatively treated patients,all of whom showed the"lollipop sign"on MRI.Conclusion HEHE is characterized by multiple subcapsular lesions,a hypovascular"slow wash-in and slow wash-out"enhancement pattern on MRI,and the lollipop sign.A multimodal imaging approach can effectively improve the diagnostic accuracy of HEHE.关键词
肝脏上皮样血管内皮瘤/磁共振成像/正电子发射计算机断层显像/多模态影像学检查/诊断效能/病理对照Key words
hepatic epithelioid hemangioendothelioma/magnetic resonance imaging/positron emission tomography-computed tomography/multimodal imaging examination/diagnostic efficacy/pathological correlation分类
医药卫生
