原发性透明细胞型肝癌的CT表现与病理对照观察

发布时间：2018-02-16 11:51

  本文关键词： 肝肿瘤 透明细胞癌 体层摄影术 X线计算机 病理学　出处：《临床放射学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨原发性透明细胞型肝癌(PCCCL)的CT表现及病理特征。方法回顾性分析12例经病理证实的PCCCL的CT图像特点,并与病理结果对照,分析总结该病的CT表现及病理基础。结果 12例患者中,11例为单发病灶,1例为肝左、右叶同时累及的多发病灶并伴有肝内及肺内多发转移。病灶最大径1.3~15.8 cm,其中直径4 cm者7例,直径10 cm者5例。平扫11例呈低或等密度,其中9例密度不均,5例内可见CT值约-10~-30 HU的脂肪密度影,且均出现在直径10 cm的病灶中。增强扫描,8例动脉期轻度强化,门静脉期持续轻度强化,病理证实透明细胞比例较高;4例动脉期明显强化,密度高于正常肝组织,门静脉期呈相对低密度,病理证实透明细胞比例相对略低。5例肿瘤内见结节状强化的软组织密度影。6例可见环形的包膜样强化。结论 PCCCL因其透明细胞比例不同,影像学表现差异较大,但CT检查能在一定程度上反映其病理特点,CT表现仍具有一定的特征性,但最终诊断仍需结合病理。
[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.
【作者单位】： 河南大学淮河医院影像科;郑州大学第一附属医院肝胆胰外科;郑州大学第一附属医院放射科;郑州大学第一附属医院病理科;
【分类号】：R730.44;R735.7
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本文编号：1515450