摘要
目的探讨肿块型肝内胆管细胞癌与低分化肝细胞癌的CT影像特征的差别。方法回顾性分析2014年2月至8月期间行CT增强检查且病理确诊为肿块型肝内胆管细胞癌患者28例、低分化肝细胞癌患者27例的临床资料,并对CT特征进行对比性研究。结果病灶的边界、形状、动脉期强化方式及门脉期强化方式在肿块型肝内胆管细胞癌组与低分化肝细胞癌组比较差异有统计学意义(P<0.05),即肿块型肝内胆管细胞癌组边界多模糊(17/28,60.7%)、以分叶状更多见(15/28,53.6%)、动脉期以边缘强化为主(21/28,75.0%)并门脉期持续强化(14/28,50.0%),低分化肝细胞癌组边界部分模糊(18/27,66.7%)、多为类圆形(17/27,63.0%)、动脉期以不均匀强化为主(20/27,74.1%)并门脉期廓清(18/27,66.7%);肝内胆管扩张率(16/28,57.1%)在肿块型肝内胆管细胞癌组明显高于低分化肝细胞癌组(4/27,14.8%,P=0.001),平均淋巴结大小及淋巴结强化程度在肿块型肝内胆管细胞癌组均明显大于或高于低分化肝细胞癌组(平均淋巴结大小:1.7 cm比1.3 cm,P=0.009;平均淋巴结强化程度:62.6 HU比51.8 HU,P=0.031)。病灶的位置、大小、平扫密度、富血供、动脉期强化程度、肝内子灶、肝包膜凹陷、胆系结石、肿瘤内动脉、静脉受侵及门静脉血栓征象在2组间比较差异均无统计学意义(P>0.05)。结论通过对CT表现特征,如肿瘤形状、边界、强化特点、胆管扩张、淋巴结的大小、强化程度的分析,可以帮助肿块型肝内胆管细胞癌与低分化肝细胞癌的鉴别诊断,为临床制定治疗方案提供客观的影像学依据以便及时制定合适的治疗方案。
Objective To discuss the CT imaging differences between mass-forming intrahepatic cholangiocarci- noma （ICC） and poorly-differentiated hepatocellular carcinoma （HCC）. Method The clinical and CT data of 28 patients with mass-forming ICC （mass-forming ICC group） and 27 patients with poorly-differentiated HCC （poorly-differentiated HCC group）, who were confirmed by pathological diagnosis in the West China Hospital from February 2014 to August 2014, were collected and analyzed retrospectively. Results The contour, margin, enhancement patterns in the arterial phase and portal vein phase of the tumor had significant differences between the mass-forming ICC group and poorly- differentiated HCC group （P〈0.05）, in other words, the lobulated shape （15/28, 53.6%）, indistinct margin （17/28, 60.7%）, peripheral enhancement in the arterial phase （21/28, 75.0%） and prolonged enhancement in the portal vein phase （14/28, 50.0%） were more often seen in the mass-forming ICC group, while the poorly-differentiated HCC group were mainly the round shape （17/27, 63.0%）, partially weil-defmed margin （18/27, 66.7%）, diffuse heterogeneous enhancement in arterial phase （20/27, 74.1%） and wash out in the portal vein phase （18/27, 66.7%）. The presence of bile duct dilatation in the the mass-forming ICC group was significantly higher than that in the poorly-differentiated HCC group [ 57.1% （16/28） versus 14.8% （4/27）, P=0.001 ]. The size and enhancement degree of lymph node in the mass-forming ICC group were significantly bigger or higher than those in the poorly-differentiated HCC group （average lymph node size： 1.7 cm versus 1.3 cm, P=0.009; average enhancement degree of lymph node： 62.6 HU versus 51.8 HU, P=0.031）. Conclusion CT features, such as tumor contour, margin, enhancement characteristics, the presence of bile duct dilatation, and the size and enhancement degree of lymph node, might help for differentiating mass-forming ICC from poorly-differentiated HCC, so that m
出处
《中国普外基础与临床杂志》
CAS
2015年第5期628-632,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
肝内胆管细胞癌
肝细胞癌
CT
肝脏
Intrahepatic cholagiocarcinoma
Hepatocellular carcinoma
Computed tomography
Liver
