肝细胞癌螺旋CT多期扫描边缘强化表现  

Peripheral Enhancement Patterns of Hepatocellular Carcinoma on Helical Multi-phase CT Scans: An Analysis of 34 Cases

作　　者：邓东[1] 龙莉玲[1] 黄仲奎[1] 卢炳丰[1] 秦宇红[1] 

机构地区：[1]广西医科大学第一附属医院放射科,南宁530027

出　　处：《临床放射学杂志》2003年第6期479-481,共3页Journal of Clinical Radiology

基　　金：广西科学基金资助项目 (桂科目 :0 0 0 70 46)

摘　　要：目的　分析肝细胞癌 (HCC)螺旋CT多期扫描边缘强化的表现形式。资料与方法　回顾性对照分析 34例经手术病理证实有包膜的HCC在螺旋CT多期扫描边缘强化的表现特点 ,着重观察肿瘤包膜、包膜密度、包膜是否完整并与病理切片对照。结果　 34例中 ,动脉期未显示明确肿瘤包膜 ,门脉期和延迟期显示肿瘤包膜呈高密度影 1 8例 (5 2 .9% ) ;动脉期肿瘤包膜呈低密度 ,门脉期和延迟期显示肿瘤包膜呈高密度 9例 (2 6 .5 % ) ;三期扫描均显示完整或不完整线状环形高密度影 4例 (1 1 .8% ) ;动、门脉期未见显示包膜 ,延迟期显示包膜呈高密度影 2例(5 .9% ) ;三期扫描均未显示明确的肿瘤包膜 1例 (2 .9% )。在多期扫描图像上 ,Ⅰ～Ⅱ级高分化HCC包膜以完整环状强化为主 ;Ⅲ～Ⅳ级低分化HCC包膜以不完整环状强化为主。与病理结果作对照 ,不完整环状强化判断包膜不完整的符合率为 92 .9%。结论　HCC螺旋CT多期扫描边缘强化的表现形式多样 ;依据CT边缘强化表现 。Objective To analyze the peripheral enhancement patterns of hepatocellular carcinoma (HCC) on helical multi phase CT scans.Materials and Methods Peripheral enhancement features on helical multi phase CT scans in 34 patients with pathologically proved capsulated HCC were retrospectively analyzed. The observation was focused on the lesion's capsule, the density and integrity of the capsule. The results were compared with the pathological findings. Results In 18 cases (52.9%), the capsule was not visualized in arterial phase and was displayed as high density shadow in portal venous phase and delayed phase. In 9 cases (26.5%), the capsule showed low density in arterial phase, while high density in portal and delayed phase. In 4 cases (11.8%), the capsule presented as intact or partly broken high density linear circle in all three phases. In 2 cases (5.9%), the capsule was not visualized in both arterial and portal phases but displayed as high density in delayed phase. In the remaining one (2.9%), the capsule was not clearly visualized in all three phases. On CT scans, the capsule in Ⅰ～Ⅱ grade well differentiated HCC was mainly manifested as intact circular enhancement, while the capsule in Ⅲ～Ⅳ grade poorly differentiated HCC was mainly characterized by broken circular enhancement. The coincidental rate with pathology in judging broken capsule was 92.9%.Conclusion A variety of peripheral enhancement patterns of HCC can be seen on helical multi phase CT scans, based on which the differentiated degree and prognosis of HCC can be predicted.

关 键 词：肝细胞癌 螺旋CT 诊断 外科手术 诊断 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]