摘要
目的 探讨肝细胞癌(HCC)累及门腔间隙(PCS)的CT、MRI表现特征和解剖基础。资料与方法 回顾性研究4 1例HCC累及PCS的随机性病例。其中CT检查2 2例,MRI检查17例,CT +MRI检查2例,均经手术、病理或临床诊断标准确诊。观察HCC累及PCS的CT、MRI表现,PCS病变与原发灶及HCC病理类型的关系。结果 HCC累及PCS的CT、MRI表现包括:门腔淋巴结(PCN)肿大(2 6 /41,6 3.4 % ) ,原发于肝尾状叶的HCC(3/41,7.3% ) ,HCC原发灶直接侵犯PCS(16 /41,39.0 % ) ,HCC累及肝十二指肠韧带(6 /41,14 .6 % )、PCS血管(2 /41,4 .9% )、PCS内胆囊管(2 /41,4 .9% ) ,HCC合并网膜孔区域腹水(2 /41,4 .9% )。PCS下段病变多为PCN肿大,上段病变多为原发灶直接侵犯。PCS病变与HCC原发灶可直接相连(18/41,4 3.9% ) ;经肝十二指肠韧带间接相连(3/41,7.3% ) ;不相连(18/41,4 3.9% ) ;直接相连并经肝十二指肠韧带间接相连(2 /41,4 .9% )。HCC累及PCS时,原发灶多为巨块型(2 2 /41,5 3.7% )。结论 HCC可使PCS受累,主要表现为PCN增大。HCC累及PCS的CT、MRI表现与原发灶的位置及病理类型有一定的相关性。
Objective To investigate the CT-MR features and the anatomic bases of the portacaval space (PCS) abnormalities resulted from hepatocellular carcinoma (HCC).Materials and Methods The CT and MR imaging data with the PCS abnormalities resulted from HCC were reviewed retrospectively. 22 cases were underwent CT scan, MR 17 cases, CT 22 cases and both of them 2 cases, which were proved by surgery, pathology or clinical and laboratory findings. The CT-MR findings and the correlations between the PCS abnormalities and the pathological type of primary tumor were observed.Results The CT-MR findings of the PCS abnormalities resulted from HCC including the enlargement of the PCN (26/41, 63.4%), HCC originating in the caudate lobe of liver (3/41, 7.3%), direct invasion from the original lesions (16/41, 39.0%), involvement of the hepatoduodenal ligament (6/41, 14.6%), and the portacaval vessels (2/42,4.9%), and the cystic duct in the PCS (2/41,4.9%), and ascites within the epiploic foramen (2/41, 4.9%). The most common finding was the enlargement of the PCN in the lower part of the PCS, and direct invasion in the upper was mainly from primary tumor. The correlations between the PCS abnormalities and the HCC lesions included direct connection (18/41, 43.9%), indirect connection through hepatoduodenal ligament (3/41, 7.3%) and both (2/4, 4.9%), and separate (18/41, 43.9%). For the pathology of HCC invasion of PCS, majority (22/41, 53.7%) of intrahepatic lesions were massive type.Conclusion The enlargement of PCN is the most common finding of the PCS abnormalities resulted from HCC. The CT, MR features of PCS abnormalities are correlated with the pathologic classifications of the HCC.
出处
《临床放射学杂志》
CSCD
北大核心
2005年第4期328-332,共5页
Journal of Clinical Radiology
基金
国家自然科学基金项目 (基金编号 :3 9470 2 2 1)
