摘要
目的探讨CT诊断早期肝癌(HCC)时易忽略的几点重要的间接征象及其临床意义。方法回顾分析12例HCC患者的早期CT检查直接征象呈阴性(无明显肿块及异常强化)时的表现,对照现有病灶,利用薄层重组、窗宽调节等技术重点观察前次扫描图像的血管形态、局部密度及轮廓等间接征象。所有病例均经随访、手术或穿刺病理证实为HCC。结果 (1)直接征象:12例HCC患者早期扫描时的平扫及增强后门静脉期均未见明显异常密度灶,增强后动脉期共发现1例病灶呈轻度强化改变,1例可疑稍低密度,境界均不清楚。(2)间接征象:12例中共1个病灶见异常扭曲增粗的供血动脉,2例表现为肝局部轮廓向外膨隆及增粗动脉,2例表现为血管推移征,6例表现血管推移征及增粗的供血动脉,1例同时表现增粗动脉、血管推移及轮廓改变。结论早期HCC直接征象不明显,血管推移、异常供血动脉及局部轮廓改变等间接征象的CT表现对诊断早期HCC具有重要的临床意义。
Objective To investigate the clinical significance of several important CT indirect signs easily overlooked in the early diagnosis of hepatocellnlar carcinoma （HCC）. Methods A retrospective analysis of 12 patients with negative direct signs on the previous CT images （ neither obvious lumps nor abnormal enhancement） was performed in order to review the CT findings in comparison with the existing lesions on the subsequent CT images. The indirect signs included vascular morphology, regional density and local contour were retrospectively observed and analyzed by the scanning technology of thin sliced reconstruction and window width adjustment. All cases with HCC were confirmed by the follow up, surgery, pathology or puncture. Results （ 1 ） Direct signs ： in the 12 cases of HCC patients, no lesions with abnormal density were found in the previous CT scanning on both plain and enhanced portal phase, but one case with mild enhancement and another case with suspected slightly hypodensity were showed with poor margin on the arterial phase. （2）Indirect signs： abnormal distorted thickening of the feeding artery in 1 case, partial contour of the liver bulging outward with thickening artery in 2 cases, vessels compressed sign in 2 cases, vessels pressed sign plus thickening artery in 6 cases, and all indirect signs occurred in 1 case were depicted in the 12 patients with HCC. Conclusion Early HCC has no remarkable direct signs, but the easily ignored indirect signs of vessels compressed, abnormal feeding artery and partial contour changes in CT manifestations deliver an important clinical significance in the diagnosis of early HCC.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第9期1286-1290,共5页
Journal of Clinical Radiology
基金
国家自然科学基金资助项目(编号:81101043)
关键词
肝癌
早期诊断
体层摄影术
X线计算机
间接征象
Hepatocellular carcinoma Early diagnosis Tomography,X- ray computed Indirect signs
