肝脏少见恶性肿瘤影像ppt课件.pptx

肝脏少见恶性肿瘤影像特点肝脏恶性肿瘤肝脏少见恶性肿瘤肝母细胞瘤最多见于右叶,其次为左右叶,肝左叶最少见
通常形成单一肿块,少数为多结节,罕见弥漫侵及整个肝脏
肿瘤总钙化率为38%~50%，大部分钙化聚集一处,此征象对肝母细胞瘤的诊断具有一定意义
肿瘤与正常肝分界清楚，肿瘤以外肝实质完全正常,在T2WI上可显示完整包膜,呈环状低信号影
肝母细胞瘤生长迅速,常于肿瘤边缘或中心部存在各种形态的出血、坏死、纤维瘢痕
瘤周尚可见绕行的肝血管影,主要为肝静脉和门静脉,多受压移位、管腔狭窄至闭塞,相邻器官受压变形。影像特点-CT影像特点-MR肝脏未分化肉瘤单发巨大肿块，囊性或囊实性，囊性成分多
实性成分位于边缘，结节状
实性成分表现为快进快出或延迟强化
出血常见肝上皮样血管内皮细胞瘤主要表现为肝内多发结节，结节多位于肝周或肝包膜下，可以融合形成较大结节，邻近包膜可形成“包膜回缩征”
文献报道约20%的病灶内可见钙化
MRT1WI呈低信号，T2WI呈中高混合信号，增强扫描病灶多为渐进性向中心延迟强化，动脉期病灶边缘轻度强化或无强化，门静脉期病灶逐渐向中心强化，但仍低于周围正常肝实质，文献中亦可呈等密度的报道影像特点肝血管肉瘤根据ＰＨＡ的生长方式将其分为４种
多发结节型、单发巨块型、巨块及结节混合型、弥漫浸润性微结节型。
恶性纤维组织肉瘤CTfindingsofhepaticMFHinclude:
large,hetero-geneouslyenhancingmasswithnecroticareas,
Singleenhancingperipheralpseudocapsulemassorcysticmasswithcysticwallandfibrousseptaenhancement
BetterenhancementofthesolidcomponentandfibrousseptamaybeseenondelayedCTscan
MRIfindingsshowthemassiswithlow-signalonT1WIandhigh-signalonT2WI.EnhancedMRIfindingswerethesamewithCTscan影像特点淋巴瘤Therearethreemorphologicpatternsinhepaticlymphoma:
largesolitarymasses(>4cm),
multiplefocalnodules
diffuseinfiltrativetype.
Hepaticlymphomaappearsaslow-densitylesionsonunenhancedandcontrast-enhancedCTscans,orhasathinenhancingrim.
TheCTcharacteristicsofhepaticsecondarylymphomaincludebloodvesselfloatingsignandenhancement
MRIfindingsshowthatthelesionspresenthypointenseonT1WIandhyperintenseonT2WI.
MRIcandistinguishdiffuseinfiltrationfromnormallivertissueincasesinwhichneithersonographynorCTdemonstratesanyabnormalities
MRIcanbeusedinNHLpatientswithaclinicalsuspicionofhepaticinvolvementwhensonographyandCTdonotshowanyfocallesions.
Positronemissiontomography(PET)usingdeoxyglucose(FDG)scanhasbeenperformedforfurtherevaluation
FDG–PET/CTshoweddiffuseintenseFDGuptakeintheenlargedliverandspleen,withsystemicFDG-avidlymphadenopathyincludingthehepatichilarnodes
However,noneoftheimagingfindingsisspecificforhepaticlymphoma.
影像特点