原发性肝类癌的CT及MRI表现  

CT and MRI findings of primary hepatic carcinoid tumor

作　　者：张亮[1] 程红岩[1] 龙行安[1] 谢朝阳 

机构地区：[1]第二军医大学附属东方肝胆外科医院放射科,上海200438 [2]河南省信阳市中医院放射科CT室

出　　处：《中华放射学杂志》2010年第4期407-410,共4页Chinese Journal of Radiology

摘　　要：目的探讨原发性肝类癌的CT及MRI表现。方法回顾性分析2003年12月至2008年11月间11例经手术病理证实的原发性肝类癌患者资料。4例行CT检查，8例行MRI检查，分析其影像表现特征。结果11例中肿瘤多发2例，表现为2个或2个以上的结节状病灶，其余9例均为单发。CT检查4例患者病灶均表现为平扫边界清楚低密度，中心可见不规则更低密度区；增强后动脉期病灶实质部分不均匀强化，中心更低密度区无强化，门静脉期及延迟期病灶边缘仍轻度强化，强化程度较动脉期减低，中心坏死区始终无强化。MRI8例患者中7例T1WI表现为边界清楚的不均匀低信号，T2WI病灶呈高信号，中心可见不规则低信号；增强后动脉期病灶边缘不均匀强化，病灶中心可见不规则无强化低信号区，门静脉期及延迟期病灶边缘仍轻度强化，边缘显示不清，病灶中心无强化低信号区范围较动脉期缩小。1例患者T1WI表现为边界清楚的囊状低信号影，囊内可见高信号，T2WI病灶呈高信号；增强后动脉期病灶边缘不均匀强化，门静脉期及延迟期呈低信号。结论平扫和动态增强CT扫描及MRI能反映原发性肝类癌的影像特点，具有一定特征性。Objective To investigate the imaging findings of primary hepatic careinoid tumor with dynamic MRI and spiral CT. Methods Eleven cases with pathologically confirmed primary hepatic carcinoid tumor were analyzed retrospectively. Four cases were examined with spiral CT, and 8 cases were examined with MRI. Results Two of 11 cases had multiple tumors, presenting as two or more nodular lesions, while the remaining 9 cases had single tumor. Four cases showed well-defined low density on the plain scan of CT, with central irregular cystic areas. Lesions enhanced unevenly on arterial phase of CT, with no enhancement in the central part. The edge of lesions showed delayed reduced enhancement on portal vein phase, than the arterial phase, while non-enhanced lesions in the center areas. Eight eases were detected by MRI, seven On MRI, 7 of 8 lesions showed uneven low signal on T1WI and high signal with central low intensity on T2WI. On arterial phase of MRI, 7 cases had uneven enhancement at the peripheral part and irregular non-enhaneed signal in center. Lesions showed delayed mild enhancement in the peripheral parts, with a relatively smaller non-enhanced central area. One case was cystic, with high signal included in the extensive low density on T1WI. The case appeared high signal on T2WI and had uneven enhancement at the edge on arterial phase, low signal on delayed phase. Condusion Primary hepatic carcinoid tumor exhibits some imaging features on plain and dynamic contrast-enhanced MRI and spiral CT, which ean be the clue for the diagnosis.

关 键 词：肝肿瘤 体层摄影术 x线计算机 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤]