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[肝脏中含与不含肝细胞癌的腺瘤样增生性病变的影像学表现]

[Imaging of adenomatous hyperplastic lesions containing and not containing hepatocellular carcinoma in the liver].

作者信息

Takayasu K, Makuuchi M, Hirohashi S, Okazaki N, Muramatsu Y, Moriyama N, Takayama T, Hasegawa H

出版信息

Nihon Shokakibyo Gakkai Zasshi. 1989 Oct;86(10):2404-12.

PMID:2556597
Abstract

In 41 patients with 54 lesions which were resected ans studied histopathologically, there were 14 lesions of adenomatous hyperplasias (AH) in 9 patients, 28 AHs containing hepatocellular carcinoma foci (early HCC, e-HCC) in 22 and 12 borderline lesions which fell between these two lesions in 10. The detectability of these lesions on imagings was evaluated. Detection rates for all lesions and e-HCCs were as follows; intraoperative sonography, 70.0%, 87.5%; Portal-CT, 71.4%; sonography, 44.4%. 64.3%; Arterial-CT, 37.5%, 50.0%; CT, 32.7%, 57.7%; angiography, 17.0%, 30.8%; Lipiodol-CT, 9.1%. 25.0%. On angiography, tumor stain was recognized in only 8 patients with e-HCC. Arterial-CT showed a relatively low density mass compared to non-tumorous area in 2 patients with e-HCC and one with borderline lesion. The median size of 54 lesions was 1.2 +/- 0.4 cm in diameter and that of AHs was 0.8 +/- 0.3 cm, the latter being significantly smaller than the other two lesions (p less than 0.01). Liver cirrhosis coexisted in 35 of 41 patients (85.4%). No complete necrosis occurred in 13 e-HCC lesions following therapeutic embolization or infusion chemotherapy in the hepatic artery.

摘要

对41例患者的54个病变进行了切除并进行组织病理学研究,其中9例患者有14个腺瘤样增生(AH)病变,22例患者有28个含肝细胞癌灶的AH(早期肝癌,e-HCC),10例患者有12个介于这两种病变之间的临界病变。评估了这些病变在影像学上的可检测性。所有病变和e-HCC的检测率如下:术中超声检查,70.0%,87.5%;门静脉CT,71.4%;超声检查,44.4%,64.3%;动脉期CT,37.5%,50.0%;CT,32.7%,57.7%;血管造影,17.0%,30.8%;碘油CT,9.1%,25.0%。在血管造影中,仅8例e-HCC患者出现肿瘤染色。2例e-HCC患者和1例临界病变患者的动脉期CT显示与非肿瘤区域相比有相对低密度肿块。54个病变的中位直径为1.2±0.4 cm,AH的中位直径为0.8±0.3 cm,后者明显小于其他两种病变(p<0.01)。41例患者中有35例(85.4%)并存肝硬化。13例e-HCC病变在肝动脉治疗性栓塞或灌注化疗后未发生完全坏死。

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