原发性肝透明细胞癌的CT及MRI表现  

CT and MRI appearances of primary clear cell carcinoma of the liver

作　　者：黄雅琴[1] 饶圣祥[1] 曾蒙苏[1] 陈财忠[1] 张澍杰[1] 李轫晨[1] 侯英勇[2] 

机构地区：[1]复旦大学附属中山医院放射科,上海市影像医学研究所,复旦大学上海医学院影像医学系,上海200032 [2]复旦大学附属中山医院病理科,上海200032

出　　处：《实用放射学杂志》2014年第11期1842-1844,1860,共4页Journal of Practical Radiology

摘　　要：目的评价CT和MRI对原发性透明细胞型肝癌（PCCCL）的诊断价值。方法回顾性分析38例经手术病理证实的PCCCL的CT和MRI表现。26例行CT检查，23例行MRI检查，其中11例同时进行了CT及MRI检查。结果CT平扫表现为低密度（n=24，92．3％）、稍高密度（n=2，7．7％）。MR T1WI呈低信号（n=19，82．6％）或混杂高信号（n=4,17．4％），脂肪抑制后信号均有不同程度下降。T2WI病灶为高或稍高信号（n=22，95．7％），1例为等低信号（n=1，4．3％），CT／MR动态增强后动脉期所有病灶均强化（n=38），门静脉期病灶呈相对低密度（n=35，92．1％）或稍高密度／高信号（n=3，7．9％）。肿瘤内结节状强化共14例。环形包膜样强化26例（26／38，68．4％）。结论PCCCL既有普通型肝癌“快进快出”的强化方式和包膜样强化的特征，又有自身特点即肿瘤内结节状强化和瘤内脂肪成分。Objective To analyze the computed tomography（CT） and magnetic resonance imaging （MRI） appearances of primary clear cell carcinoma of the liver （PCCCL） and evaluate the value in the diagnosis of the disease. Methods CT and MR images of 38 patients of pathologically confirmed PCCCL were evaluated retrospectively. Twenty-six patients underwent CT, 23 underwent MRI, and 11 underwent both CT and MRI. Results In pre-contrast CT scanning, 24 PCCCLs appeared hypodense and 2 hyperdense. As for MRI 19 of the 23 PCCCLs were hypointense and 4 were iso-hypointense on T1WI. While on T2 WI,22 cases were heterogeneously hyperintense, and 1 was iso-hypointense. On the arterial phase of CT /MRI, all cases presented intense enhancement, and on the portal venous phase, 35 cases（ 35/38,92. 1 %） were relatively hypodense/hypointense and 3 were slightly hyperdense/hyperintense. Among the tumors larger than 3 cm （ n = 22 ）, nodular enhancement pattern was found in 14 cases （63. 6 %, 14/22）. The capsular rim enhancement was demonstrated in 26 cases. Conclusion PCCCL showed similar dynamic enhancement pattern as common hepatocellular carcinoma, but also depicted specific imaging features.

关 键 词：透明细胞癌 肝细胞肝癌 计算机体层成像 磁共振成像 

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