肝癌骨转移为首发症状的影像学诊断  

Imaging Diagnosis of Bone Metastasis As the First Manifestation of Hepatocellular Carcinoma

作　　者：徐秋贞[1] 蔡锡类[1] 李跃华[1] 

机构地区：[1]南京铁道医学院附属医院放射科

出　　处：《实用放射学杂志》1997年第5期266-268,280,共4页Journal of Practical Radiology

摘　　要：目的：提高对肝癌以骨转移为首发症状的认识。方法：复习３例经手术和／或病理证实的骨转移为首发症状的肝癌影像学表现。结果：额顶及骶骨各１例，均表现为溶骨性骨破坏及局部出现软组织肿块。血管造影显示病变区有丰富的血供。腰椎１例，为腰１～２椎体溶骨破坏。结论：我国为肝癌高发区，肝癌的血行转移是最常见的，但骨转移为首发症状者比较少见，尤其发生于颅骨，往往因病史及肝区症状不明显而误诊。我们认为对任何溶骨性骨破坏病例，应经常要考虑肝癌骨转移的可能，建议常规作肝脏的Ｂ超、ＣＴ或ＡＦＰ检测。Objective: To have a better understanding of the significance of imaging appearance of bone metastasis as the first manifestation of the hepatocellular carcinoma(HCC).Three cases of HCC with initial sign of bone destruction confirmed by pathology were reviewed. Results: Metastasis occured in skull bone and sacrum was respectively 1 case,both of them demonstrated osteoytic destruction and local soft tissue mass as well as abundant blood supplies angniographically. The third case showed destruction of upper lumbar vertebral bodies. Conclusion:Incidence of HCC is high in China. Dissemination of the HCC through blood is common. However, bone metastasis as the first sign of the HCC is quite rare, especially in the skull and easily misdiagnosed. we suggest that AFP test and US,CT examination of liver may be as a routine in the case with osteolystlc destruction of the skull or trunk.

关 键 词：肝肿瘤 骨转移 血管造影 

分 类 号：R735.704[医药卫生—肿瘤] R738.104[医药卫生—临床医学]