小肝细胞癌的不典型CT表现分析
|
摘要
目的分析小肝细胞癌的不典型CT表现,以提高对不典型小肝细胞癌的诊断准确率。方法回顾性分析我院2010年1月至2016年11月经病理证实的不典型小肝细胞癌18例,均行CT平扫及动态增强扫描。结果所有病例均为单发病灶,其CT表现形式分为以下11种:1)平扫低密度-动脉期高密度-门脉期高密度的5例。2)平扫低密度-动脉期高密度(接近同层主动脉)-门脉期低密度的2例。3)平扫低密度-动脉期高密度-门脉期等密度的1例。4)平扫低密度-动脉期边缘环形高密度、环不完整见壁结节-门脉期环及结节呈低密度的2例。5)平扫低密度-动脉期边缘环形高密度、环不完整见结节-门脉期环及结节呈高密度的1例。6)平扫低密度-动脉期低密度-门脉期低密度的2例。7)平扫低密度-动脉期低密度-门脉期等密度的1例。8)平扫低密度-动脉期等密度-门脉期呈低密度的1例。9)平扫等密度-动脉期低密度-门脉期低密度的1例。10)平扫等密度-动脉期高密度-门脉期等密度的1例。11)平扫高密度-动脉期高密度-门脉期高密度的1例。以上动脉期高密度未做接近同层主动脉标记的均为低于同层主动脉、高于肝脏密度。结论小肝细胞癌的动态增强CT扫描有多种不典型的强化表现,正确认识这些不典型的强化表现,可以减少误诊率。
Objective To analyze the atypical CT findings of small hepatocellular carcinoma, so as to improve the accuracy of diagnosis. Methods A retrospective analysis was performed on 18 cases of atypical small hepatocellular carcinoma that were pathologically confirmed between January 2010 and November 2016 in our hospital. Results All the cases were single lesions, and the CT manifestations were divided into the following 11 types: 1) 5 cases of low density-arterial phase high density-portal phase high density. 2) two cases of low density-arterial high density(close to the same level of aorta)-portal low density. 3) 1 case with low density-arterial phase high density-portal phase equal density. 4) 2 cases with low density at the edge of arterial stage and low density at the edge of plain scanning, with incomplete ring. 5)1 case with low density-arterial edge annular density, incomplete ring, nodular-portal ring and nodular density. 6)two cases of low density-arterial low density-portal low density were swept. 7) 1 case with low density-arterial phase low density-portal phase equal density. 8) 1 case presented low density in the scanning low-arterial isopyme-portal period. 9) one case of isodensity-low density in arterial phase-low density in portal phase. 10) one case of isodensityarterial density-portal density. 11) 1 case with histological density-arterial density-portal density. The higher arterial density was lower than that of the same aorta and higher than that of the liver. Conclusion The dynamic enhanced CT scan of small hepatocellular carcinoma has a variety of atypical enhanced manifestations, and the correct recognition of these atypical enhanced manifestations can reduce the misdiagnosis rate.
Objective To analyze the atypical CT findings of small hepatocellular carcinoma, so as to improve the accuracy of diagnosis. Methods A retrospective analysis was performed on 18 cases of atypical small hepatocellular carcinoma that were pathologically confirmed between January 2010 and November 2016 in our hospital. Results All the cases were single lesions, and the CT manifestations were divided into the following 11 types: 1) 5 cases of low density-arterial phase high density-portal phase high density. 2) two cases of low density-arterial high density(close to the same level of aorta)-portal low density. 3) 1 case with low density-arterial phase high density-portal phase equal density. 4) 2 cases with low density at the edge of arterial stage and low density at the edge of plain scanning, with incomplete ring. 5)1 case with low density-arterial edge annular density, incomplete ring, nodular-portal ring and nodular density. 6)two cases of low density-arterial low density-portal low density were swept. 7) 1 case with low density-arterial phase low density-portal phase equal density. 8) 1 case presented low density in the scanning low-arterial isopyme-portal period. 9) one case of isodensity-low density in arterial phase-low density in portal phase. 10) one case of isodensityarterial density-portal density. 11) 1 case with histological density-arterial density-portal density. The higher arterial density was lower than that of the same aorta and higher than that of the liver. Conclusion The dynamic enhanced CT scan of small hepatocellular carcinoma has a variety of atypical enhanced manifestations, and the correct recognition of these atypical enhanced manifestations can reduce the misdiagnosis rate.
引文
[1]周康荣.螺旋CT[M].上海:上海医科大学出版社,1998,87-95.
[2]李国珍.临床C T诊断学[M].北京:中国科学技术出版社,1997,404-425.
[3]郭启勇.实用放射学[M].第3版.北京:人民卫生出版社,2013,819-820.
[4]许玲,王龙胜,郑穗生,等.少血供不典型小肝癌CT表现与病理对照研究[J].安徽医学,2013,34(3):312-314.
[5]刘建国,刘福尧,张新广.多层螺旋C T增强扫描对不典型强化的肝癌影像分析及诊断价值[J].医学影像学杂志,2014,24(11):1946-1949.
[6]韦菊临,覃志龙.小肝癌的不典型CT表现分析及鉴别诊断[J].放射学实践,2010,25(12):1375-1379.
[7]徐达生,陈君禄,黄兆民.临床CT诊断学[M].广东:广东科技出版社,1998,179-180.
[8]郑可国,徐达生,沈静娴.小肝细胞癌边缘强化的螺旋CT表现与病理对照研究[J].中华放射学杂志,2003,37(5):413-416.
[9]薛武荣,张鹏飞,韩宏明,等.不典型小肝癌的螺旋CT表现(附10例报告)[J].实用放射学杂志,2012,28(9):1390-1392.
[10]郑可国,徐达生,沈静娴.少血供小肝细胞癌的螺旋CT表现并与病理对照[J].中华放射学杂志,2003,37(10):930-934.
[11]周梅玲,严福华.CT在肝结核瘤诊断中的价值[J].中国医学计算机成像杂志,2005,11(2):115-118.
[12]梁长虹,刘于宝,刘再毅.腹部病变MSCT诊断[M].天津:天津科技翻译出版有限公司,2013,58-59.
[2]李国珍.临床C T诊断学[M].北京:中国科学技术出版社,1997,404-425.
[3]郭启勇.实用放射学[M].第3版.北京:人民卫生出版社,2013,819-820.
[4]许玲,王龙胜,郑穗生,等.少血供不典型小肝癌CT表现与病理对照研究[J].安徽医学,2013,34(3):312-314.
[5]刘建国,刘福尧,张新广.多层螺旋C T增强扫描对不典型强化的肝癌影像分析及诊断价值[J].医学影像学杂志,2014,24(11):1946-1949.
[6]韦菊临,覃志龙.小肝癌的不典型CT表现分析及鉴别诊断[J].放射学实践,2010,25(12):1375-1379.
[7]徐达生,陈君禄,黄兆民.临床CT诊断学[M].广东:广东科技出版社,1998,179-180.
[8]郑可国,徐达生,沈静娴.小肝细胞癌边缘强化的螺旋CT表现与病理对照研究[J].中华放射学杂志,2003,37(5):413-416.
[9]薛武荣,张鹏飞,韩宏明,等.不典型小肝癌的螺旋CT表现(附10例报告)[J].实用放射学杂志,2012,28(9):1390-1392.
[10]郑可国,徐达生,沈静娴.少血供小肝细胞癌的螺旋CT表现并与病理对照[J].中华放射学杂志,2003,37(10):930-934.
[11]周梅玲,严福华.CT在肝结核瘤诊断中的价值[J].中国医学计算机成像杂志,2005,11(2):115-118.
[12]梁长虹,刘于宝,刘再毅.腹部病变MSCT诊断[M].天津:天津科技翻译出版有限公司,2013,58-59.