摘要
目的 研究小肝细胞癌边缘强化的螺旋CT双期表现及其与病理组织学之间的关系。方法 分析经手术病理证实的螺旋CT双期扫描表现为边缘强化的小肝细胞癌病人 17例、共 18个病灶的CT征象 ,并与手术病理结果比较。结果 动脉期 17个病灶边缘部的强化环不完整、环壁厚薄不一 ,环壁附近出现小结节状强化 ,只有 1个病灶边缘部的强化环完整、环壁厚薄一致。门静脉期边缘部的强化环和壁上小结节的密度降至低于或等于正常肝的密度。病理分型 :16个病灶是梁索型 ,2个病灶是硬化型。肿瘤细胞的分化程度是 :Ⅰ级者 2个病灶 ,Ⅱ级者 14个病灶 ,Ⅲ级和Ⅳ级者各有 1个病灶。病灶边缘部血管多于中央部者 12个病灶 ,病灶边缘部和中央部血管均较少者有 6个病灶。3个病灶边缘部有假包膜 ,10个病灶有小灶性坏死。结论 小肝细胞癌边缘强化的螺旋CT双期增强扫描表现具有一定的特点 ,可以与肝脏其他表现为边缘强化的病变进行鉴别。
Objective To study the helical CT dual-phase feature of peripheral enhancement in small hepatocellular carcinoma (SHCC) and to evaluate its correlation with the histopathology. Methods The helical CT dual-phase feature of peripheral enhancement in SHCC was analyzed in 17 cases with 18 lesions, all the lesions were confirmed by operation and histopathology. Results In 17 lesions, peripheral enhancement ring of the lesions wasn′t intact, the thickness of peripheral enhancement ring wasn′t uniform, and small nodular enhancement was found inside the peripheral enhancement ring in hepatic arterial phase (HAP). In 1 lesion, the peripheral enhancement ring of the lesion was intact and the thickness of peripheral enhancement ring was uniform in HAP. The density of the peripheral enhancement ring and the small nodular enhancement decreased to hypodense or isodense than the normal liver parenchyma in portal venous phase. Pathologic pattern: 16 lesions were trabecular type and 2 lesions were scirrhous type. The differentiation of the tumor cell was grade I in 2 lesions, grade Ⅱ in 14 lesions, grade Ⅲ in 1 lesion, and grade Ⅳ in 1 lesion, respectively. In 12 lesions, the vessels were richer in the lesion border than that in the lesion center. In 6 lesions, the vessels were less rich in both center and border. In 3 lesions, the pseudo-capsule was showed in the border of the lesion. In 10 lesions, the flecks of necrosis were demonstrated in the border and/or center of the lesion. Conclusion The helical CT dual-phase feature of peripheral enhancement in SHCC is characteristic, and SHCC might be distinguished from other hepatic diseases with peripheral enhancement.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2003年第5期413-416,共4页
Chinese Journal of Radiology
基金
广东省卫生厅研究基金资助 (A1998173)
