發(fā)布時間：2018-01-15 13:28

  本文關(guān)鍵詞：肉瘤樣肝細(xì)胞癌的磁共振征象分析　出處：《放射學(xué)實踐》2017年08期 　論文類型：期刊論文

  更多相關(guān)文章： 肝腫瘤 肝細(xì)胞癌 肉瘤樣 磁共振成像 病理學(xué) 診斷

【摘要】：目的:探討肉瘤樣肝細(xì)胞癌(SHC)的磁共振成像表現(xiàn)。方法:回顧性分析經(jīng)手術(shù)病理證實的12例SHC的MRI及臨床資料。全部患者行MRI平掃及增強(qiáng)檢查,由2位放射科醫(yī)師主要從病灶的數(shù)目、大小、形態(tài)、分布、信號特點(diǎn)(出血、壞死、囊變等)、邊界(有無包膜等)、強(qiáng)化特征及鄰近改變(侵犯、轉(zhuǎn)移、肝實質(zhì)有無肝硬化等)這8個方面分析其MRI特征。結(jié)果:12例中10例患有慢性肝炎,8例AFP陰性。9例單發(fā),3例多發(fā),共16個病灶,病灶最大徑為1.3~12.1cm,平均(4.9±3.3)cm。MRI顯示肝內(nèi)病灶信號不均勻,中心可見壞死囊變,實性成分呈環(huán)形或不規(guī)則分隔樣強(qiáng)化,尤以周邊部分動脈期明顯強(qiáng)化,門脈期及延遲期呈廓清表現(xiàn),伴或不伴有包膜延遲強(qiáng)化,病灶侵犯鄰近器官伴肝門淋巴結(jié)腫大。免疫組化染色結(jié)果顯示Hepa陽性12例,EMA陽性8例、間葉組織標(biāo)志物Vimentin陽性12例。結(jié)論:肉瘤樣肝細(xì)胞癌的臨床和MRI表現(xiàn)有一定特征性,但確診需依賴組織病理學(xué)檢查。
[Abstract]:Objective: to study SHC in sarcomatoid hepatocellular carcinoma (HCC). Methods: the MRI and clinical data of 12 cases of SHC proved by operation and pathology were analyzed retrospectively. MRI plain scan and enhanced examination were performed in all patients. The number, size, morphology, distribution, signal characteristics (hemorrhage, necrosis, cystic degeneration, etc.), boundary (with or without capsule, etc.), enhancement features and adjacent changes (invasion, metastasis) of the lesions were studied by two radiologists. Results among 12 cases, 10 cases had chronic hepatitis and 8 cases had AFP negative. 9 cases had multiple lesions in 3 cases (16 lesions). The maximum diameter of the lesion was 1.3 鹵12.1 cm, with an average of 4.9 鹵3.3 cm. MRI showed that the signal intensity of the lesion in the liver was uneven, and the necrotic cysts could be seen in the center. The solid components were enhanced in a circular or irregular manner, especially in peripheral arterial phase, portal and delayed phase with or without capsular delayed enhancement. The lesions involved adjacent organs with hilar lymphadenopathy. Immunohistochemical staining showed that Hepa was positive in 12 cases and EMA positive in 8 cases. Conclusion: the clinical and MRI features of sarcomatoid hepatocellular carcinoma are characteristic, but the diagnosis depends on histopathological examination.
【作者單位】： 復(fù)旦大學(xué)附屬中山醫(yī)院放射科;上海交通大學(xué)醫(yī)學(xué)院附屬蘇州九龍醫(yī)院放射科;
【分類號】：R445.2;R735.7
【正文快照】： 肉瘤樣肝細(xì)胞癌(sarcomatoid　hepatocellular　car-cinoma,SHC)是肝細(xì)胞癌的一種特殊病理亞型[1],較為罕見,其惡性程度較高,患者預(yù)后較差[2]。目前國內(nèi)外對SHC的磁共振表現(xiàn)報道較少[3],筆者回顧性分析了12例經(jīng)病理證實的SHC患者的病例資料,分析其臨床、磁共振影像特征及病理，

本文編號：1428554