小肝细胞癌病理结构与动脉期不强化机制的探讨  

Small Hepatic Cell Carcinomas:Unenhancementin Arterial Phase with its Pathology

作　　者：涂备武[1] 周康荣[1] 严福华[1] 

机构地区：[1]复旦大学医学院中山医院放射科

出　　处：《中国医学计算机成像杂志》2002年第5期318-321,共4页Chinese Computed Medical Imaging

摘　　要：研究小肝细胞癌(HCCs)的病理结构以探讨其动脉期不强化的病理机制。材料和方法 :收集18个HCCs病灶 ,动脉期均用同层动态扫描 ,手术标本做病理大切片 ,常规HE和免疫组化染色。将病灶四等分 ,记录坏死、透明细胞变和脂肪变区域大小等。测透明细胞变区和一般癌区肿瘤微血管密度(IMVD)。测量对应CT图像不强化区域大小和CT值。结果 :18个病灶中14个不同程度坏死。透明细胞变和脂肪变各2个。仅少数病灶内上述区域大小可与CT表现对应。透明细胞变区IMVD明显少于一般癌区。结论 :小HCCs动脉期不强化常见原因是坏死出血、囊变和纤维化等。透明细胞变引起动脉期不强化或强化不明显的原因是微血管密度下降致血供减少。To study the pathological structure of the unehanced area of small hepat ic cell carcinomas(HCCs) in the arterial phase so as to investigate the patholog ical mechanism.Materials and Methods:Eighteen HCCs lesions were collected with s ingle-level dynamic CT scan.The surgical specimens were examinated with gross s ection and HE and immunohistochemical stain.The lesion was divided into quarter parts.The number and size of the area of necrosis,hyaline-cell and fatty degene ration were recorded and correlated with unenhanced areas in the CT images.The i ntratumoural microvessel density(IMVD) was also measured.Results:There was necro sis with different degree in 14 lesions.Two lesions had the hyaline-cell area a nd 2 had fatty degeneration.There were fewer lesions showed the findings in CT i mage identical to the pathological specimen.Compared with typical-cell area of the lesion,IMVD in the hyaline-cell area was significantly reduced.Conclusion:T he usual causes of unenhanced small HCCs in the arterial phase were necrosis,hem orrhage,cystic and fibrinoid degeneration.The hyaline-cell area in the lesion r esulted in the low blood supply to the lesion because of the reduced MVD and the n can make it unhanced.The fatty degeneration is another cause.

关 键 词：小肝细胞癌 增强 病理对照 病理结构 动脉期不强化 病理机制 同层动态扫描 

分 类 号：R735.7[医药卫生—肿瘤]