肉瘤样肝细胞癌的磁共振征象分析

发布时间：2018-01-15 13:28

  本文关键词：肉瘤样肝细胞癌的磁共振征象分析　出处：《放射学实践》2017年08期 　论文类型：期刊论文

  更多相关文章： 肝肿瘤 肝细胞癌 肉瘤样 磁共振成像 病理学 诊断

【摘要】：目的:探讨肉瘤样肝细胞癌(SHC)的磁共振成像表现。方法:回顾性分析经手术病理证实的12例SHC的MRI及临床资料。全部患者行MRI平扫及增强检查,由2位放射科医师主要从病灶的数目、大小、形态、分布、信号特点(出血、坏死、囊变等)、边界(有无包膜等)、强化特征及邻近改变(侵犯、转移、肝实质有无肝硬化等)这8个方面分析其MRI特征。结果:12例中10例患有慢性肝炎,8例AFP阴性。9例单发,3例多发,共16个病灶,病灶最大径为1.3~12.1cm,平均(4.9±3.3)cm。MRI显示肝内病灶信号不均匀,中心可见坏死囊变,实性成分呈环形或不规则分隔样强化,尤以周边部分动脉期明显强化,门脉期及延迟期呈廓清表现,伴或不伴有包膜延迟强化,病灶侵犯邻近器官伴肝门淋巴结肿大。免疫组化染色结果显示Hepa阳性12例,EMA阳性8例、间叶组织标志物Vimentin阳性12例。结论:肉瘤样肝细胞癌的临床和MRI表现有一定特征性,但确诊需依赖组织病理学检查。
[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 卤12.1 cm, with an average of 4.9 卤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.
【作者单位】： 复旦大学附属中山医院放射科;上海交通大学医学院附属苏州九龙医院放射科;
【分类号】：R445.2;R735.7
【正文快照】： 肉瘤样肝细胞癌(sarcomatoid　hepatocellular　car-cinoma,SHC)是肝细胞癌的一种特殊病理亚型[1],较为罕见,其恶性程度较高,患者预后较差[2]。目前国内外对SHC的磁共振表现报道较少[3],笔者回顾性分析了12例经病理证实的SHC患者的病例资料,分析其临床、磁共振影像特征及病理，

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