原發(fā)性透明細(xì)胞型肝癌的CT表現(xiàn)與病理對(duì)照觀察
發(fā)布時(shí)間:2018-02-16 11:51
本文關(guān)鍵詞: 肝腫瘤 透明細(xì)胞癌 體層攝影術(shù) X線計(jì)算機(jī) 病理學(xué) 出處:《臨床放射學(xué)雜志》2017年09期 論文類型:期刊論文
【摘要】:目的探討原發(fā)性透明細(xì)胞型肝癌(PCCCL)的CT表現(xiàn)及病理特征。方法回顧性分析12例經(jīng)病理證實(shí)的PCCCL的CT圖像特點(diǎn),并與病理結(jié)果對(duì)照,分析總結(jié)該病的CT表現(xiàn)及病理基礎(chǔ)。結(jié)果 12例患者中,11例為單發(fā)病灶,1例為肝左、右葉同時(shí)累及的多發(fā)病灶并伴有肝內(nèi)及肺內(nèi)多發(fā)轉(zhuǎn)移。病灶最大徑1.3~15.8 cm,其中直徑4 cm者7例,直徑10 cm者5例。平掃11例呈低或等密度,其中9例密度不均,5例內(nèi)可見CT值約-10~-30 HU的脂肪密度影,且均出現(xiàn)在直徑10 cm的病灶中。增強(qiáng)掃描,8例動(dòng)脈期輕度強(qiáng)化,門靜脈期持續(xù)輕度強(qiáng)化,病理證實(shí)透明細(xì)胞比例較高;4例動(dòng)脈期明顯強(qiáng)化,密度高于正常肝組織,門靜脈期呈相對(duì)低密度,病理證實(shí)透明細(xì)胞比例相對(duì)略低。5例腫瘤內(nèi)見結(jié)節(jié)狀強(qiáng)化的軟組織密度影。6例可見環(huán)形的包膜樣強(qiáng)化。結(jié)論 PCCCL因其透明細(xì)胞比例不同,影像學(xué)表現(xiàn)差異較大,但CT檢查能在一定程度上反映其病理特點(diǎn),CT表現(xiàn)仍具有一定的特征性,但最終診斷仍需結(jié)合病理。
[Abstract]:Objective to investigate the CT features and pathological features of primary clear cell carcinoma (PCCC). Methods the CT features of 12 cases of pathologically proved PCCCL were retrospectively analyzed and compared with the pathological results. The CT findings and pathological basis of the disease were analyzed and summarized. Results among the 12 cases, 11 cases were single lesions and 1 case was left liver. Multiple lesions in the right lobe were simultaneously involved with intrahepatic and intrapulmonary multiple metastases. The maximum diameter of the lesions was 1.3 ~ 15.8 cm, including 7 cases with a diameter of 4 cm, 5 cases with a diameter of 10 cm, and 11 cases with low or equal density on plain scan. The fat density of CT value about -10 ~ 30 Hu could be seen in 9 cases with uneven density, and all of them appeared in the lesions with diameter of 10 cm. Enhancement scan showed slight enhancement in arterial phase in 8 cases, and continued mild enhancement in portal phase in 8 cases. It was proved by pathology that the percentage of transparent cells in 4 cases was significantly enhanced in arterial phase, and the density was higher than that in normal liver tissue, and the portal vein phase was relatively low density. Pathological findings showed that the percentage of transparent cells was slightly lower in the tumors. 6 cases with nodular enhanced soft tissue density showed circular capsular enhancement. Conclusion the imaging findings of PCCCL vary greatly due to its different proportion of transparent cells. But CT can reflect its pathological features to a certain extent, but the final diagnosis still needs to be combined with pathology.
【作者單位】: 河南大學(xué)淮河醫(yī)院影像科;鄭州大學(xué)第一附屬醫(yī)院肝膽胰外科;鄭州大學(xué)第一附屬醫(yī)院放射科;鄭州大學(xué)第一附屬醫(yī)院病理科;
【分類號(hào)】:R730.44;R735.7
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本文編號(hào):1515450
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