原发性肝癌血供特点的螺旋CT表现及其与病理学特性的相关性研究  

The spiral CT manifestations of the blood supply of primary hepatocellular carcinoma: correlation with pathologic findings

作　　者：黄娟[1] 周翔平[1] 刘荣波[1] 陈宪[1] 许崇永[1] 严志汉[1] 徐建英[1] 

机构地区：[1]华西医科大学附属第一医院放射科,成都610041

出　　处：《中华放射学杂志》2000年第11期753-756,共4页Chinese Journal of Radiology

摘　　要：目的　探讨原发肝细胞性肝癌 (PHCC)的血供方式及其与癌细胞分化程度、组织学类型的相关性。方法　盲法下观察 5 0例经手术病理证实的PHCC病例的螺旋CT强化方式及影像学表现 ,将PHCC的血供分为 4型。并将PHCC血供类型与癌细胞分化程度 (Edmonson分类法 )和组织学类型 (WHO分类法 )的相关性作统计学分析。结果　 5 0例PHCC中 ,肝动脉供血型共 36例 ,占 72 % ;肝动脉和门静脉双重供血型共 6例 ,占 12 % ;门静脉和少血供型各 4例 ,各占 8%。 7例I级PHCC中 ,肝动脉供血型 2例、门静脉供血型 2例 ,双重血供 3例 ;16例Ⅲ级和 9例Ⅳ级PHCC为肝动脉供血。 3例纤维硬化型PHCC均为少血供 ,8例实体型PHCC均为肝动脉供血 ,34例梁状型PHCC中 2 6例由肝动脉供血。结论　大多数PHCC为肝动脉供血型 ,部分为门静脉供血型、双重供血型和少血供型。Objective To study the correlation between the CT features of tumor blood supplies and the pathological changes in primary hepatocellular carcinoma (PHCC). Methods Fifty cases with surgically and pathologically proved PHCC underwent spiral CT scanning (plain+dual phase). One research group blindly evaluated the CT films obtained. According to tumor contrast enhancement and signals showed on CT, the patterns of PHCC was divided into 4 types: arterial blood supplying, portal blood supplying, arterial combining with portal blood supplying, and poorly blood supplying. Microscopically, PHCC was respectively classified into grade I to Ⅳ with Edmonson′s standard, and into 4 types (trabecular, pseudoglandular, compact, scirrhous) with WHO histological grading standard. At last, the CT features of tumor blood supplies were correlated with pathologic changes. Results 36(72%) cases were supplied by hepatic arterial blood, 6(12%) by arterial combining with portal blood supplying, 4(8%) by portal, and 4(8%) were poorly blood supplying. The patterns of tumor blood supplies in PHCC correlated with tumor cells differentiation ( P <0.05). PHCC with better tumor cells differentiation was more associated with portal blood supplies. The patterns of tumor blood supplying in PHCC correlated with the histological type of the tumor cell ( P <0.05). All of the scirrhous PHCC were lack of blood supplies, the entire compact and most of the trabecular PHCC were supplied by arterial blood. Conclusion The most of PHCC were supplied by hepatic arterial blood and others were supplied by portal blood, arterial combining with portal blood or lack of blood supplies. Evaluation of tumor blood supplies in PHCC is considered to be useful in differential diagnosis and treatment of PHCC

关 键 词：原发性肝癌 血供特点 螺旋CT 病理学 诊断 

分 类 号：R735.7[医药卫生—肿瘤]