混合型肝癌18例CT影像分析  

Analysis of CT image in combined hepatocellular carcinoma and cholangiocarcinoma of 18 cases

作　　者：余庆华[1,2] 吴建满[1,2] 

机构地区：[1]福建医科大学省立临床医学院 [2]福建省立医院放射科,福州350001

出　　处：《福建医药杂志》2014年第6期120-122,共3页Fujian Medical Journal

摘　　要：目的分析混合型肝癌的CT影像特点,提高影像诊断的正确性。方法回顾性分析经手术病理证实的18例混合性肝癌的临床及CT影像资料。结果 CT表现为单发(8例)或多发(10例)结节或肿块;平扫呈低密度(16例)或混杂稍高密度(2例);增强扫描:13例动脉期周边中度-明显不均匀强化,静脉期及实质期病灶周边强化程度降低,而病灶内部出现延迟强化;2例动脉期为全瘤中度不均匀强化,静脉期及实质期病灶内部分区域强化程度降低;2例动态增强表现为持续低密度;1例动脉期及静脉期全瘤明显强化,实质期呈等密度。不完整假包膜8例,合并肝内胆管扩张5例,致门脉狭窄7例,淋巴结转移11例,侵犯周围组织5例。结论混合型肝癌的CT表现有一定特征,熟悉其影像特征并结合临床表现,有助于提高术前诊断水平。Objective To investigate CT features of combined hepatocellular carcinoma and cholangiocarcinoma（HCCCC）,and to improve preoperative diagnostic accuracy.Methods CT findings and clinical labratory examinations of 18 cases with HCC-CC were studied retrospectively,all cases were histologically confirmed.Results CT showed single（8）and multiple（10）nodules or masses,with low-attenuation（16）or mixed hyper-attenuation（2）in plan scan.After contrast enhancement：13cases appeared peripheral moderate or remarkable heterogeneous enhancement in arterial phase,delayed enhancement components within tumors were found in dynamic scan,while＂rapid in-wash out＂enhancement components within tumors were found;2cases appeared peripheral moderate heterogeneous enhancement in arterial phase,while＂rapid in-wash out＂enhancement components within tumors were found in portal and balanced phase;2cases showed mild heterogeneous enhancement in all phases;1case showed remarkable enhancement in arterial and portal phases,showed even in balanced phase.There were 8cases with pseudocapsule,5with duct dilation,7with portal vein stenosis,11 with lymphonode metastasis.Conclusion There are some CT features of HCC-CC,being familiar with their CT and clinical manifestations will contribute to improving preoperative diagnostic accuracy.

关 键 词：肝脏肿瘤 混合型肝癌 体层摄影术 

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