原发性肝脏透明细胞癌的CT诊断分析

肝脏 ›› 2022, Vol. 27 ›› Issue (10): 1073-1075.

原发性肝脏透明细胞癌的CT诊断分析

路利军, 郭建伟, 陈敬信, 张明

710300 西安陕西省森林工业职工医院(路利军,郭建伟,陈敬信);西安交通大学医学部公共卫生学院(路利军);西安交通大学第一附属医院影像科(张明)

收稿日期:2021-12-11 出版日期:2022-10-31 发布日期:2022-11-22
通讯作者: 张明,Email:Zmmri@163.com

CT in the diagnosis of primary clear cell carcinoma of the liver

LU Li-jun^1,2, GUO Jian-wei¹, CHEN Jing-xin¹, ZHANG Ming³

1. Shaanxi Forest Industry Worker Hospital, Xi'an 710300, China;
2. School of Public Health, Xi' an Jiao-tong University Health Science Center, Xi' an 710068, China;
3. Department of Radiology, the First Affiliated Hospital, Xi' an Jiaotong University, Xi' an 710068, China

Received:2021-12-11 Online:2022-10-31 Published:2022-11-22
Contact: ZHANG Ming, Email:Zmmri@163.com

摘要/Abstract

摘要： 目的探讨原发性肝脏透明细胞癌(PCCCL)的CT表现。方法收集7例经病理证实的PCCCL的临床及CT影像资料,分析其CT表现。7例均行CT平扫及动态增强扫描。结果 7例PCCCL均为单发病灶,6例位于肝右叶,1例位于肝左叶,瘤径4~14 cm,平均5.3 cm。CT平扫7例病灶均表现为不均匀低密度,瘤内可见坏死,其中2例可见脂肪变;5例边界清楚,可见假包膜,2例边界不清。CT动态增强扫描7例病灶均呈不均匀强化,其中3例动脉期强化,静脉期呈相对低密度影;2例动脉期轻度强化,静脉期持续强化呈略高密度影;2例动脉期呈结节样明显强化,静脉期及延迟期呈渐进性强化,结节样强化范围逐渐扩大。结论 PCCCL的CT平扫表现有一定特征,增强表现不典型与肿瘤透明细胞比例有关,分析其CT特征对该疾病的准确诊断有一定价值。

关键词: 肝肿瘤, 透明细胞肝癌, X线计算机, 动态增强扫描

Abstract: Objective To investigate the spiral computed tomography (CT) imaging features of primary clear cell carcinoma of liver (PCCCL). Methods The clinical and CT imaging data of 7 patients with PCCCL confirmed by pathology were collected and retrospectively analyzed. All the 7 cases underwent plain and dynamic enhanced CT scan. Results All the 7 cases of PCCCL were single lesions. Among them, 6 lesions located in the right lobe of liver, 1 lesion located in left lobe of liver. The diameter of tumor ranged from4 to 14 cm, with an average of 5.3 cm. Uneven low density and necrosis could be observed in 7 cases, and 2 cases with lipogenesis. There were 5 cases with clear boundary and pseudo-capsule, 2 cases with unclear boundary. Dynamic contrast-enhanced CT scans showed nonuniform enhancement in 7 cases. Enhancement in arterial phase and low density in venous phase were observed in 3 cases. Slight enhancement in arterial phase and continuous enhancement presented high density in venous phase were observed in 2 cases. The imaging of 2 cases showed nodular marked enhancement in arterial phase, progressive enhancement in venous phase and delayed phase, the extent of nodular enhancement gradually expanded. Conclusion There are some certain features in plain CT scan imaging of PCCCL, and the untypical enhancement features are related to the proportion of clear cell in the tumor. The characteristics of CT is valuable for the accurate diagnosis of PCCCL.

Key words: Liver neoplasm, Clear cell carcinoma of liver, X-ray computer tomography, Dynamic enhanced scanning

路利军, 郭建伟, 陈敬信, 张明. 原发性肝脏透明细胞癌的CT诊断分析[J]. 肝脏, 2022, 27(10): 1073-1075.

LU Li-jun, GUO Jian-wei, CHEN Jing-xin, ZHANG Ming. CT in the diagnosis of primary clear cell carcinoma of the liver[J]. Chinese Hepatolgy, 2022, 27(10): 1073-1075.

参考文献

[1] 刘斌, 杨雪, 陈枫, 等. 磁共振成像在透明细胞型肝癌诊断中的价值. 磁共振成像, 2021,12:21-24.
[2] 刘斌, 孙君, 陈枫, 等. 临床影像综合模型在透明细胞型肝癌精准诊断中的价值. 中国医学影像学杂志, 2021,29:897-901.
[3] 李智宇, 毕新宇, 赵建军, 等. 原发性透明细胞型肝细胞肝癌的临床特点及预后分析. 中华肿瘤杂志, 2013,35:140-143.
[4] 李涛, 樊嘉, 钦伦秀, 等. 透明细胞型肝癌的临床病理特点及预后. 中华普通外科杂志, 2012,27:96-99.
[5] 刘志升, 马维东, 李强. 原发性肝透明细胞肝癌的临床病理学特点及预后分析:附4 3例. 中华肝胆外科杂志, 2008,14:528-532.
[6] 王运韬, 倪敏, 陈自谦, 等. 原发性肝透明细胞癌的影像学表现与临床病理对照. 临床军医杂志, 2012,40:1500-1503, 插1.
[7] 马秀华, 薛鹏, 肖智博, 等. 原发性肝脏透明细胞癌的影像学诊断与临床应用价值. 中华肝胆外科杂志, 2013,19:491-494.
[8] 陈枫, 赵晶, 李宏军, 等. 原发性透明细胞型肝癌的影像表现及比较分析研究. 临床放射学杂志, 2019,38:1418-1423.
[9] 刘衡, 董泽天, 柏永华, 等. 原发性透明细胞型肝癌的CT表现及其病理基础. 中国CT和MRI杂志, 2014,12:57-59.
[10] 王瑜, 陈自谦, 李铭山, 等. 原发性透明细胞型肝癌的MRI表现与临床病理对照. 临床放射学杂志, 2014,33:1532-1535.
[11] 何瀚平, 钟群, 王燕华, 等. 原发性肝透明细胞癌的MRI表现. 功能与分子医学影像学杂志(电子版), 2018,7:1450-1454.
[12] 周梅玲, 严福华, 李清海, 等. 原发性透明细胞型肝癌的CT和MRI诊断. 中华放射学杂志, 2010,44:950-953.
[13] 黄雅琴, 饶圣祥, 曾蒙苏, 等. 原发性肝透明细胞癌的CT及MRI表现. 实用放射学杂志, 2014,30:1842-1845.
[14] 张娜, 许万博. 原发性肝脏透明细胞癌的影像学特征. 实用放射学杂志, 2019,35:321-323.
[15] 黄峥峥, 郑穗生, 王龙胜, 等. 原发性透明细胞型肝癌的三期增强CT表现与病理分化程度研究. 安徽医学, 2015,36:1478-1481.
[16] 斯依提阿迪拉, 娜岳, 陈海霞, 等. 肝脏血管平滑肌脂肪瘤的临床病理学特征分析. 华中科技大学学报(医学版), 2015,44:476-479.