螺旋CT诊断外生型肝癌的价值  

Diagnostic Value of Spiral CT in Pedunculated Hepatocellular Carcinoma

作　　者：丁可[1] 刘满荣[2] 杨新官[1] 邱维加[1] 

机构地区：[1]桂林医学院附属医院放射科,广西桂林541001 [2]桂林医学院附属医院超声科,广西桂林541001

出　　处：《实用放射学杂志》2010年第12期1757-1759,1767,共4页Journal of Practical Radiology

摘　　要：目的 分析外生型肝癌的临床特点及螺旋CT表现,探讨螺旋CT诊断外生型肝癌的价值.方法 对本院2004-01-2009-06期间收治的17例经病理证实的外生型肝癌行螺旋CT平扫加双期增强扫描,回顾性分析外生型肝癌的临床特点及螺旋CT表现.结果 HBsAg阳性者14/17例,AFP（＋）者 13/17例,合并肝硬化的占58.82%（10/17）,肝功能Child分级14/17例为A级.综合观察CT轴位及多平面重组（MPR）图像,13/17例外生型肝癌有蒂,其基底与相应肝叶或肝段相连,2/17例与邻近肝叶分界不清但无明确瘤蒂,只有2例与肝脏呈分离状态.CT增强扫描病变呈＂速升速降＂型强化的占88.24%（15/17）,有2/17为轻度欠均匀强化.通过轴位、MPR以及最大密度投影（MIP）图像,可观察到15/17例外生型肝癌有肝动脉供血,另有2例可见胃十二指肠动脉的分支参与供血.结论 外生型肝癌有明显的临床及CT表现特征.Objective To evaluate the clinical features and spiral CT findings of pedunculated hepatocellular carcinoma （PHCC） and to investigate the diagnostic value of spiral CT in PHCC. Methods 17 cases with PHCC proved pathologically during 2004--01 --2009--06 in our hospital underwent plain CT and contrast--enhanced CT scans. The clinical characteristics and spiral CT findings of PHCC were analyzed retrospectively. Results HBsAg（＋） was found in 14（14/17） patients,AFP（＋） was found in 13（13/17） patients, and 10/17 cases had hepatic cirrhosis,Child--Pugh A of liver function accounted for 14/17. By review the CT image of axial view and MPR,PHCC in 13 （13/17） cases had peduncle and the fundament connected with corresponding hepatic lobes or hepatic segments, 2/17 cases had indefinite borderline with liver,only 2 cases were separated from linver completely. Enhanced CT scanning showed the tumors were enhanced quickly during hepatic artery--phase but were relative low density during hepatic portal vein-- phase in 88.24 ^（15/17）. The blood--supply of the tumors from hepatic artery was found in 15/17 cases,among them, 2 cases had the branch of gastroduodenal artery to participate blood--supply. Conclusion Pedunculated hepatocellular carcinoma is of conspicuous clinical presentations and CT characteristics.

关 键 词：肝脏 肝细胞癌 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]