肝占位性病变CT误诊为原发性肝癌30例分析  

Analysis of 30 cases of liver space occupying lesions misdiagnosed as primary liver cancer by CT

作　　者：冯潇[1] 龙莉玲[1] 彭鹏[1] 张小波[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2013年第3期411-414,共4页Journal of Practical Radiology

摘　　要：目的 探讨肝占位性病变CT误诊为肝癌的几种常见原因，以提高鉴别诊断水平。方法 回顾性分析30例CT误诊为肝癌但经病理证实为其他肝脏占位性病变的64层CT平扫和动态增强扫描资料，结合病理结果分析其影像学表现。结果 30例中，肝良性占位性病变共15例，包括肝细胞局灶性结节性增生（FNH）4例、肝硬化再生结节（RN）5例、肝腺瘤（HA）4例、炎性假瘤（IP）2例，肝恶性占位性病变共15例，包括转移性腺癌11例、未分化胚胎性肉瘤（UES）2例、肝神经内分泌癌2例，所有病例术前CT均误诊为肝癌。结论 被误诊病变表现与肝癌相似点多、病变本身表现不典型和PLC在CT上的不典型表现多是误诊的常见原因。加深对易误诊病变的了解，结合临床资料及其他先进的影像学技术综合分析，可进一步提高诊断准确性。Objective To investigate the causes of misdiagnosis of hepatic lesions as primary liver cancer（PLC） oi1 CT and im prove our clinical ability of differential diagnosis. Methods The plain CT scan and enhancement scanning images of 30 patients with misdiagnosis of hepatic carcinoma were analyzed retrospectively. Results Among the 30 cases, 15 cases were hepatic benign lesions including 4 cases of focal nodular hyperplasia, 5 cases of cirrhosis regeneration nodules, 4 cases of hepatic adenoma and 2 cases of inflammatory pseudotumor. Another 15 cases were malignant lesions including 11 cases of metastatic adenocarcinoma, 2 cases of undifferentiated embryonal sarcoma and 2 cases of hepatic neuroendocrine carcinoma. All of the cases were preoperatively misdiagnosed as liver cancer by CT. Conclusion High similarity between misdiagnosed lesions and PLC , their atypical manifestation in CT findings and the special pathological change and the growth mode of PLC result on the atypical CT findings were the main causes leading to misdiagnosis. Understanding the misdiagnosed lesions thoroughly, a comprehensive analysis of the images combined with clinical data and other advanced imaging techniques can improve the diagnostic accuracy.

关 键 词：肝占位性病变 计算机体层成像 误诊 原发性肝癌 

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