Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
AJR Am J Roentgenol. 2009 Dec;193(6):W482-9. doi: 10.2214/AJR.08.1818.
The purpose of this study was to evaluate according to size and degree of cellular differentiation the multiphasic MDCT enhancement pattern of hepatocellular carcinoma (HCC) smaller than 3 cm in diameter in patients with cirrhosis.
In 155 consecutively registered patients (126 men, 29 women; mean age, 58.4 years), 204 pathologically proven HCCs smaller than 3 cm were detected at multiphasic MDCT. Three radiologists in consensus classified the relative attenuation of the tumors compared with the surrounding liver parenchyma as hyperattenuation, isoattenuation, or hypoattenuation on biphasic (n = 86) and triphasic (n = 69) CT scans.
The prevalent enhancement patterns of HCC differed depending on tumor size. The prevalent pattern of HCC measuring 20-29 mm was arterial hyperattenuation with venous washout (47%, 47/101). The prevalent enhancement patterns of HCC smaller than 10 mm and HCC measuring 10-19 mm were isoattenuation during the arterial and portal venous phases (29%, 6/21) and hyperattenuation and isoattenuation during the arterial and portal venous phases (33%, 27/82). The typical HCC enhancement pattern (arterial hyperattenuation with venous washout) was identified in 48% (67/141) of the moderately and poorly differentiated HCCs and in 13% (8/63) of well-differentiated HCCs.
The prevalent enhancement patterns of HCC smaller than 3 cm on multiphasic MDCT scans differed depending on tumor size and cellular differentiation. HCCs smaller than 2 cm and well-differentiated HCCs frequently had atypical enhancement patterns.
本研究旨在根据大小和细胞分化程度评估肝硬化患者直径小于 3cm 的肝细胞癌（HCC）的多期 MDCT 增强模式。
在 155 例连续登记的患者（126 例男性，29 例女性；平均年龄 58.4 岁）中，多期 MDCT 检测到 204 例经病理证实的直径小于 3cm 的 HCC。三位放射科医生在共识的基础上，将肿瘤相对于周围肝实质的相对衰减程度分为双期（n=86）和三期（n=69）CT 扫描的高增强、等增强或低增强。
HCC 的常见增强模式取决于肿瘤大小。20-29mm 的 HCC 最常见的增强模式是动脉期高增强伴静脉洗脱（47%，47/101）。直径小于 10mm 和 10-19mm 的 HCC 最常见的增强模式是动脉期和门静脉期等增强（29%，6/21）和动脉期和门静脉期高增强和等增强（33%，27/82）。典型的 HCC 增强模式（动脉期高增强伴静脉洗脱）在中、低分化 HCC 中占 48%（67/141），在高分化 HCC 中占 13%（8/63）。
多期 MDCT 扫描中直径小于 3cm 的 HCC 的常见增强模式取决于肿瘤大小和细胞分化程度。直径小于 2cm 和高分化 HCC 常表现出非典型的增强模式。
