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目的探讨肝脏小血管瘤合并动静脉瘘在多层螺旋CT多期动态增强扫描的表现,分析其形成机制和影响因素。方法回顾性分析33例52个肝脏小血管瘤的多期动态增强CT表现,动静脉瘘的诊断标准为:肝动脉期病灶周围肝实质一过性楔形或不规则形强化区,在门静脉期和延迟期变为稍高密度或等密度;或者表现为动脉期在上述楔形强化区域同时可见到早显的细小门静脉分支影。分析肝脏小血管瘤合并动静脉瘘的几率与病灶强化方式的关系。结果52个肝脏小血管瘤病灶中13个(25%)出现动静脉瘘,均表现为肿瘤周围一过性强化区,其中有7个病灶动脉期在上述楔形强化区域同时可见到早显的细小门静脉分支影,在21个快速强化型瘤体中有11个(52.4%)合并动静脉瘘,而31个慢速强化的瘤体中仅仅有2个(6.5%)合并动静脉瘘(P<0.05)。结论肝脏小血管瘤合并动静脉瘘并非很少见。合并动静脉瘘的肝小血管瘤更容易出现在快速强化型瘤体中。
Objective To investigate the performance of multi-slice helical CT enhanced multi-slice spiral CT in the diagnosis of small hemangiomas with arteriovenous fistula and to analyze the mechanism and influencing factors. Methods Retrospective analysis of 33 cases of 52 small hemangiomas with multi-phase dynamic contrast-enhanced CT showed that the diagnostic criteria of arteriovenous fistula were as follows: a transient wedge-shaped or irregular-shaped area of hepatic parenchyma surrounding hepatic arterial lesions, Delay into a period of high density or isodense density; or manifested as the arterial phase in the above wedge-shaped enhanced area can be seen at the same time showed the early appearance of fine branches of the portal vein. Analysis of the relationship between hemangiomas with arteriovenous fistula and enhancement of lesion. Results Thirteen (25%) of the 52 hepatic hemangiomas showed arteriovenous fistulas, all of which showed transient enhancement around the tumor. Seven of the lesion arterial stages showed conspicuous early in the wedge-shaped enhancement area There were 11 (52.4%) arteriovenous fistulas in 21 fast-bodied tumors with portal vein branching, whereas only 2 of 31 (6.5%) slow-booting tumors combined with arteriovenous fistula (P < 0.05). Conclusions Hepatic small hemangiomas with arteriovenous fistula are not uncommon. Hepatic hemangiomas with arteriovenous fistulas are more likely to occur in rapidly-fortified tumors.