肝臟海棉狀血管瘤：電腦斷層檢查和血管攝影

Cavernous Hemangioma of the Liver: Computed Tomography and Angiography

姜仁惠(J H Chiang) ； 楊建芳(C F Yang) ； 謝滄泰(C T Hsieh) ； 周宜宏(Y H Chou) ； 王家槐(J H Wang)

《中華放射線醫學雜誌》 8卷4期 (1983/12) Pp. 279-292

摘要

肝臟海棉狀血管瘤是最常見的肝臟良性腫瘤。通常體積小且無症狀，常在肝膽系檢查時意外發現。較大型的腫瘤可因壓迫而使病人感到不適。兩年半來，榮民總醫院放射線部總共為22位肝臟海棉狀血管瘤病人作電腦斷層檢查(CT)和血管攝影；其中8位作例行CT檢查，14位作CT血流動力學掃描(dynamic CT)。22位病人當中，男性12位，女性10位。平均年齡50歲。20位病人都有典型的血管變化，在早期動脈相就有對比劑儲積在腫瘤靠邊處，並向中心擴散，持續至少30秒鐘以上；1例血管無異常發現，1例惡化型血管內皮瘤有明顯的動靜脈分流。4cm以上之較大型腫瘤，其對比後CT影像常見邊緣性高密度，並向中心延伸，密度持續2至30分鐘不等；有些腫瘤在注射對比劑後變為均勻性高密度，有些則看來體積縮小。血管變化和CT影像多可吻合。對大部分肝臟海棉狀血管瘤來說，CT檢查可提供正確的診斷。

並列摘要

Cavernous hemangioma of the liver is the most common benign tumor found at angiography and its feature can be characteristic. It usually shows a hypervascular lesion with groups of vascular spaces. Contrast medium pool in spaces and last to the late venous phase. The feeding arteries are usually not dilated. No A-V shunting are found. 22 cases of cavernous hemangioma of the liver have been examined by both angiography and CT in recent two and half years in VGH. 14 of them received time sequential dynamic CT scanning. There is evidence of time-related enhancement of the lesion. Post contrast CT scan shows a high density seen mostly in the periphery of the mass and the high density progressly toward the center. Some of the lesions become isodense or hyperdense. Some become smaller, and smaller. The enhanced density lasts a rather long period of time and sometimes up to 30 minutes. It is rather characteristic in disgnosing the cavernous hemangioma of the liver and comparable with the angiographic pattern. We believe, dynamic CT has the specificity toward the diagnosis of cavernous hemangioma of the liver. Unnecessary biopsy can be avoided.