原发性肝细胞性肝癌局部淋巴结转移的螺旋CT表现  

CT features of local lymph node spreading of primary hepatocelluar carcinoma

作　　者：黄娟[1] 周翔平[1] 姚晋[1] 陈宪[1] 漆锐[1] 

机构地区：[1]华西医科大学附属第一医院放射科,成都610041

出　　处：《放射学实践》2004年第3期190-193,共4页Radiologic Practice

摘　　要：目的 :探讨原发性肝细胞性肝癌 (HCC)局部淋巴结转移的CT表现及病灶的大小、边缘形态与出现局部淋巴结肿大的关系。方法 :盲法下分析 162例HCC病灶的CT扫描影像。结果 :162例病灶中 48例 (占 2 9.63 %)出现局部淋巴结转移。其中肝门组、门腔间隙组以及腹主动脉组最为常见 ,其出现概率分别为 12 .96%,14 .81%,11.73 %。局部淋巴结转移出现概率与病灶大小及边缘形态有统计学意义 (P <0 .0 5 )。结论 :HCC发生局部淋巴结转移的概率为 2 9.63 %。HCC最主要的淋巴转移途径为肝内深、浅淋巴管经肝门淋巴结、门腔间隙淋巴结、腹腔干旁淋巴结至腹主动脉旁淋巴结 ,并常表现为多组、跳跃式淋巴结转移。发生局部淋巴结转移的HCC更容易出现在体积较大和无包膜型HCC中。HCC的CT分型能够反映其病理演变。Objective:To study the CT features of lymphadenopathy of HCC and discuss the correlation between the prevalence of lymph node metastases and the size and boundary types of HCC.Methods:162 patients with HCC confirmed by histology or clinical examinations underwent spiral CT scans.Results:48 of 162 patients had lymphadenopathy (29.63%).The most frequent sites of the enlarged lymph nodes were hepatic hilum (12.96%),portacaval space(14.81%),and retroperitoneum (11.73%),respectively.The incidence of lymphadenopathy in HCC was significantly higher in those HCC with larger primary foci and without capsule.Conclusion:The prevalence of lymph node metastases in HCC is 29.63%.The lymphadenopathy of HCC often occures in multiple sites and in a “skipping” pattern,and is inclined to be observed in HCC with larger primary foci and without capsule.The CT classification of HCC may represent its pathological process as well.

关 键 词：原发性肝细胞性肝癌 淋巴结转移 螺旋CT 影像学诊断 淋巴结肿大 

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