摘要
摘要目的通过对21例单发性肝转移瘤及34例单发性原发性肝癌的CT表现的对比分析,寻找到两种肿瘤的影像学上的异同点,以期提高两种肿瘤的认知水平及其CT鉴别诊断水平。方法收集经手术和病理证实的单发性肝转移瘤2例和原发性肝癌34例,男47例,女8例,平均年龄52岁,最小的38岁,最大的66岁。采用螺旋CT平扫和动态增强扫描。结果21例单发性肝转移瘤的平扫表现为边缘清楚的低密度肿块影,呈“环靶征”或“牛眼征”改变;3例位于肝右后叶,形态与局部肝形态较为一致,占位效应不明显。原发性肝癌表现为边缘欠清的低密度类圆形影34例,都伴有肝硬化增强扫描,肝转移瘤于门静脉期均有强化,表现为周边强化或全瘤强化;肝动脉期强化的为较小的肿块。肝癌26例动脉期有强化,门静脉期强化迅速消退;有肝动脉-门静脉短路的6例;8例有门静脉瘤栓形成,3例有下腔静脉瘤栓形成。结论单发性肝转移瘤与原发性肝癌在CT表现上各有特点,平扫肝转移瘤边界均较清楚,呈圆形,增强扫描于门静脉期有强化,有“环靶征”或“牛眼征”改变,一般不伴有肝硬化。部分转移瘤可表现为无占位效应。原发性肝癌肿块多为类圆形,边界不清;增强发生在动脉期。大部分肝癌都伴有肝硬化;部分伴肝动脉-门静脉分流现象及门静脉和下腔静脉瘤栓形成。
Objective To differentiate between solitary PHCC and metastatic hepatic carcinoma by comparatively analyzing their CT appearances. Methods 55 cases with solitary 34 PHCC and 21 metastatic hepatic carcinoma, including 47 man and 8 women, median age 52 years , all verified by resection and pathology. All of the patients underwent plain and dynamic enhancement scan with spiral CT. Results Plain scan: 21 solitary metastatic tumors all showed well-defined margins and hypodense changes. central low density areas in lesions ( bull-eye sign) were seen .3 lesions located in the right back hepatic lobe, which shape is consistent with liver parenchymal modality. 34 solitary PHCC which were often accompanied by liver cirrhosis all showed ill-defined margins,similar round. Enhancement: All metastatic tumors showed edge or whole enhancement in the portal phase.26 PHCC demonstrated whole or partial notable enhancement in the arterial phase. Part of PHCC was seen Arteriovenous diversion and Portal vein or cava inferior tumor thrombus. Conclusion Metastatic tumors showed well-defined margins ,round shape in plain scan and were enhanced in portal phase.Bull-eye sign was often a symbol of metastatic tumors. Part of metastatic tumors showed no location effect. However, a majority of PHCC which were detected in cirrhotic livers demonstrated similar-round, ill-defined margins and were enhanced in the arterial. Part of PHCC had arteriovenous diversion phenomenon and tumor thrombus in portal vein or cava inferior .
出处
《江西医药》
CAS
2004年第5期313-314,共2页
Jiangxi Medical Journal
关键词
肝转移瘤
原发性肝癌
肿块
门静脉期
平扫
肿瘤
肝硬化
异同点
强化
认知水平
solitary
metastases hepatic carcinoma
primary hepatocellular carcinoma(PHCC)
computed tomography(CT)
differential diagnosis
