目的：探讨肝脾血管肉瘤的影像学表现及病理学特征，提高其影像诊断水平。方法：回顾性分析经手术病理证实的6例肝脾血管肉瘤的临床、影像学表现，并与病理结果进行对比分析。结果：6例肝脾血管肉瘤中，肝脏3例，脾内2例，肝、脾内均发1例。1例为单发肿块型，1例为多发结节型，1例为巨块型，1例巨块结节混合型，1例为弥漫结节型，另有1例影像学检查仅见脾大，未见明显结节及肿块。有2例病灶内出现T1WI高信号出血灶，1例主病灶周围有多发子灶。5例CT/MRI增强扫描中，均表现为不均匀向心性、延迟性强化，其中1例弥漫结节型呈结节、网格样持续强化并向内部充填，1例多发结节型，结节信号不一，强化方式不一，部分出现向心性渐进强化的特点，部分呈环形强化，其余3例表现为病灶边缘不均匀向心性、延迟性强化。病理示肿瘤细胞多呈条索样、上皮样、巢瘤样，可见大小不等的血管腔相互吻合，肿瘤细胞沿血管腔生长，部分可见乳头状结构，部分肿块内可出现出血、坏死。结论：肝脾血管肉瘤平扫常表现为混杂密度/信号肿块，病灶内常见囊变、出血，CT/MRI增强扫描对诊断有重要意义，多表现为病灶边缘或中心动脉期环形或不规则强化，静脉期及延迟期有向心性或离心性渐进强化。

Objective: To investigate the imaging findings and pathological features of hepatic and splenic angiosarcoma and to improve the diagnostic level of imaging. Methods: The clinical and imaging findings of 6 hepatic and splenic angiosarcomas confirmed by operation and pathology were retrospectively analyzed and compared with pathological results. Results: Six cases of hepatic and splenic angiosarcoma occurred in liver(3 cases), spleen(2 cases), both liver and spleen(1 case). One case was single mass type, 1 case was multiple nodular type, 1 case was massive type, 1 case was mixed type, 1 case was diffuse nodular type, and 1 case had no obvious nodule and lump. Among them, T1WI high-signal hemorrhage was found in 2 cases, and 1 case had multiple lesions around the main lesion. In 5 cases of CT/MRI enhanced scan, all of them showed uneven centripetal and delayed enhancement. One case of diffuse nodular type showed nodular and reticular continuous enhancement and filling to the interior, and one case of multiple nodular type showed different nodular signals, the strengthening methods were also different, some of them showed the characteristics of progressive centripetal enhancement, some were ring-shaped enhancement, and the other 3 cases showed uneven centripetal and delayed enhancement of the lesion edge. Pathological findings showed that the tumor cells were mostly strips, epithelioid and nest like, and the vascular lumens of different sizes were anastomosed with each other, and tumor cells grew along the vascular lumen, and some of them showed papillary structures, some of tumors had hemorrhage and necrosis. Conclusion: The hepatic and splenic angiosarcoma usually presents as mixed density/signal mass on plain scan, and cystic change and hemorrhage are common in the lesion. CT/MRI enhanced scanning is of great significance for the diagnosis of angiosarcoma, most of which are annular or irregular enhancement at the edge of the lesion or in the central arterial phase, and centripetal or centrifugal progressive enhancement in the venous and delayed phases.