少血供小肝癌的螺旋CT表现并与病理对照  

Helical CT appearance of hypovascular small hepatocellular carcinoma with pathologic correlation

作　　者：郑可国[1] 许达生[1] 沈静娴[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080

出　　处：《中华放射学杂志》2003年第10期930-934,共5页Chinese Journal of Radiology

基　　金：广东省卫生厅研究基金 (A1998173 )

摘　　要：目的　研究螺旋CT双期增强扫描低密度小肝癌的CT表现及其病理学基础。方法分析经手术病理证实的螺旋CT双期增强扫描表现为低密度的小肝癌 2 5例共 2 7个病灶的CT征象和病理学改变。结果　 (1)平扫病灶边界模糊不清者有 16个病灶 ,边界清楚者有 11个病灶 ;增强后病灶边界模糊者只有 7个病灶 ,边界清楚者有 2 0个病灶 ,同时病灶边缘轮廓轻度不规整。 (2 )平扫瘤内呈均匀性低密度者有 18个病灶 ,瘤内密度不均匀者有 9个病灶 ;增强后瘤内密度均匀者只有 6个病灶 ,瘤内密度不均匀、有多个小斑点状密度更低区者有 2 1个病灶。结论　螺旋CT双期增强扫描低密度小肝癌的CT表现特点是 :平扫病灶边界模糊 ,增强后病灶边界变清楚并呈轻度不规整 ,同时病灶内密度不均匀 ,有多个小斑点状密度更低区。Objective To study the helical CT dual-phase enhancement manifestation of the hypodense small hepatocellular carcinoma, and to evaluate its correlation with the histopathology. Methods The CT signs and its histopathologic changes were analyzed in 25 cases with 27 hypodense lesions in helical CT dual-phase enhancement. All the lesions were confirmed as small hepatocellular carcinoma by operation and histopathology. Results (1) On unenhanced scan, 16 lesions were with obscure borders and 11 lesions were with well-delineated borders. On enhanced scan, only 7 lesions were with obscure borders and the other 20 lesions were with well-delineated borders, and their contours were slightly irregular. (2) On unenhanced scan, 18 lesions showed homogeneous hypodensity and 9 lesions showed heterogeneous hypodensity. On enhanced scan, only 6 lesions showed homogeneous hypodensity and the other 21 lesions showed heterogeneous hypodensity with multiple flecks of more hypodense areas. Conclusion The helical CT dual-phase enhancement characteristic manifestations of hypodense small hepatocellular carcinoma were as follows: the border of the lesion was obscure on unenhanced scan, however the border of the lesion became well-delineated and slightly irregular, and there were multiple flecks of more hypodense areas in the lesions after enhancement. This might be an important character in distinguishing hypodense small hepatocellular carcinoma from other hypodense diseases in the liver.

关 键 词：少血供小肝癌 CT表现 病理学 螺旋CT检查 双期增强扫描 小肝细胞癌 

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