肝细胞癌胆管内生长的MRI、CT表现及病理基础  

Invasion of biliary tract by primary hepatocellular carcinoma: correlative study of MR and CT imaging manifestations and pathology

作　　者：周翔平[1] 彭其芳[1] 陈宪[1] 宋彬[1] 闵鹏秋[1] 沈明恩 徐剑英[1] 

机构地区：[1]华西医科大学附属第一医院放射科

出　　处：《中华放射学杂志》1998年第8期549-551,共3页Chinese Journal of Radiology

摘　　要：目的探讨肝细胞癌（ＨＣＣ）胆管内生长的影像学检查方法及其表现。方法经手术和病理证实为本病１８例，其中ＭＲＩ检查１７例，ＣＴ增强扫描１１例。结果ＭＲＩ检查均显示ＨＣＣ肝内原发病变和胆管内生长的癌栓；ＣＴ检查除１例肝内原发病变未检出外其余病变均显示。结论ＨＣＣ胆管内生长影像学上可见二类：一是原发病灶直接侵犯相邻胆管，二是原发病灶癌细胞种植在较远的胆管内形成癌栓。ＭＲＩ。Purpose To investigate the imaging manifestations of invasion of biliary tract by primary hepatocellular carcinoma (HCC) with correlation of pathology, and to assess the diagnostic values of related imaging modalities. Methods 18 documented HCC cases with surgically and pathologically proved invasion of biliary tract were included in the study. 17 had MRI examinations, 11 underwent contrast enhanced CT scans. Results Both the primary intrahepatic HCC foci and the secondary intraductal tumor thrombi within the biliary tract were clearly demonstrated on MR images in all 17 cases. CT scanning depicted the primary HCC lesions in 10 cases and the intraductal tumor growth in 11 cases with one primary focus being missed. Conclusion Two patterns of invasion of the biliary tract by HCC can be observed on MR and CT images. One is the direct local ingrowth into the neighboring biliary tract by HCC and the other is distant intraductal tumor implantation with tumor thrombus formation. MR and CT are shown to yield more accurate diagnostic information and better lesion characterization than direct cholangiography.

关 键 词：肝细胞癌 胆道转移 磁共振成像 CT 病理 

分 类 号：R735.704[医药卫生—肿瘤]