血管瘤和腺瘤課件

Benignfocalliverlesions——Haemangioma＆AdenomaVocabularyhaemangioma

[hi,m?nd?i'?um?]血管瘤adenoma[,?d?'n??m?]腺瘤metastasis[m?'t?st?s?s]新陳代謝，轉(zhuǎn)移瘤dilemmas

[d?'lem?]困境degeneration[d?,d?en?'re??(?)n]變性，惡化parenchyma

[p?'re?k?m?]實質(zhì)peripheral[p?'r?f(?)r(?)l]外圍的heterogeneous[,het(?)r?(?)'d?i?n??s]不均勻的，多樣化的regress[r?'gres]逆行，倒退malignancy[m?'l?gn?ns?]惡性（腫瘤等）patchy['p?t??]不調(diào)和的HaemangiomaThesecommon,benignlesionsarehighlyvascular,composedofanetworkoftinybloodvessels.They

maybesolitaryormultiple.Mosthaemangiomasare

smallandfoundincidentally.Theyarerarelysymptomatic

butdocause

diagnosticproblemsasthey

canbe

indistinguishablefromlivermetastases.Theyfrequentlyexhibitslightly

increasedthrough-transmission,withposterior

enhancement,particularlyiflarge.Thisisprobably

duetotheincreasedbloodcontentcomparedwith

thesurroundingliverparenchyma(Fig.4.9).Figure4.9(A)Threesmallhaemangiomas(arrows).(B)A

haemangiomaisdemonstratedintheanteriorpartof

therightlobeoftheliver.Becausethebloodwithinthehaemangiomaisveryslow-flowing,itisusuallynotpossibletodemonstrateflowwithcolourorpowerDopplerandthelesionsappearavascularonultrasound.Microbubblecontrastagentsdemonstrateaperipheral,globularenhancementwithgradualcentripetalfillingofthelesion,helpingto

characterizethemanddifferentiatehaemangiomafrom

malignantlesions.Whenfoundinchildren,haemangiomastendto

be

largeanddoproducesymptoms.These

massesproduceshuntingofbloodfromtheaortaviathemainhepaticarteryand,inextremecases,present

withresultingcardiacfailure.Theyareoftenheterogeneous

inappearanceandlargervesselswithin

themmaybeidentifiedwithDoppler.Although

manyregressoveraperiodoftime,othersmay

havetobeembolizedwithcoilsunderradiological

guidancetocontrolthesymptoms.Inpatientswithnocausetosuspectmalignancy,itmaybesuggestedthattheappearancesofasmall,well-defined,hyperechoicmassareduetobenign

haemangioma.Follow-upscanswilldemonstrate

noappreciablechangeovertime.However,where

doubtexists,itisusefultoreferthepatientforfurther

imaging,suchasMRIscanning,tocharacterize

thelesionconfidently.Figure4.9(C)Onadministrationofmicrobubble

contrastagent,thelesionin(B)demonstratesperipheral,globularenhancement,withgradualcentripetalfilling,consistentwithhaemangioma.LargeradenomasmaycontainvigorousarterialflowonDoppler,butthisisnotpathognomonicand

doesnotdifferentiateitfromamalignantlesion.(A)Adenomainsegment5inayoung

womanontheoralcontraceptivepill.(B)Anunusual

exampleofcysticdegenerationinalargeadenoma.Theymaycausepain,particularlyiftheyhaemorrhage,

andmaybepalpable.Surgicalremovalisthe

managementofchoice,althoughtheyoccasionally

regressiftheoralcontraceptiveisdiscontinued.Ultrasoundisusefulinmonitoringpatie