1、肝脏海绵状血管瘤,Cavernous Hemangioma of Liver,Outline,most common benign1%-20% in different placeF M90% solitary,Cavernous Hemangioma of Liver,Clinical symptoms,Most of them never cause symptoms or health problems.and are incidentally discovered at medical examination, surgery, or autopsy(尸检).right upper a
2、bdominal pain、pain, nausea(恶心)、enlargement of the liver；,Larger hemangiomas can rupture, causing severe pain and bleeding into the abdomen that may be severe or even shock .,Pathological appearance,Cavernous hemangioma is resulted from endothelial cells proliferation（增殖）.,The tumor consists in large
3、 (cavernous) spaces, lined by tumor endothelial cells ， These interconnected spaces are filled with blood and separated by a fibrous tissue。,Oral contraceptives （口服避孕药）and steroids(类固醇) may accelerate the growth of a hemangioma. Whether or not these drugs actually induce the formation of the hemangi
4、oma is unclear.,Causes,Diagnosis（CT）,round or subround ，smooth, lobulated, homogeneous, sometimes septated hypodense mass relative to the adjacent liver,Nonenhanced CT scans,contrast-enhanced CT scan,arterial phase,The lesion appears peripheral nodular enhancement（边缘结节状强化），the center of the lesion t
5、ypically remains hypodense.,portal venous phase,contrast enhancement progresses centripetally（向心性强化） until fills in the whole lesion.The enhanced level is similar to the abdominal aorta.,delayed phase The whole lesion is homogeneous enhancement ,the density is higher or equal to the surrounding norm
6、al liver (some tumors have low-density center which represent fibre or thrombus ).,快进慢出早出晚归,Diagnosis（MRI）,T1WI,T1WI smooth, lobulated, homogeneous, sometimes septated hypointense mass relative to the liver,Nonenhanced MRI scans,T2WI markedly hyperintense mass， the signal intensity of the lesion is
7、similar to that of the cerebrospinal fluid.,light bulb sign 灯泡征,T2WI,contrast-enhanced MRI scan,These images demonstrate the progressive, centripetal contrast enhancement in a hemangioma.,早出晚归快进慢出,o hemangiomas can demonstrate immediate homogeneous enhancement (lesions 5cm),Differential diagnosis,肝囊肿Hepatic cyst,原发性肝癌primary hepatic carcinoma,肝转移瘤 hepatic metastatic tumor,nonenhancement,bull eyes sign牛眼征,快进快出,annular enhancement,Medical history (hepatitis、cirrhosis ),primary lesion,Halo sign（晕征）,Thank you.,
