对比增强超声检查下肝内胆管癌合并肝细胞癌的影像学特征：与临床病理结果的相关性
Imaging features of combined hepatocellular-cholangiocarcinoma on contrast-enhanced ultrasound: correlation with clinicopathological findings.
作者信息
Ye J, Xie X, Lin Y, Liu B, Wang W, Huang X, Huang G
机构信息
Department of Medical Ultrasonics, Division of Interventional Ultrasound, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China.
Department of Medical Ultrasonics, Division of Interventional Ultrasound, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China.
出版信息
Clin Radiol. 2018 Mar;73(3):237-243. doi: 10.1016/j.crad.2017.10.003. Epub 2017 Nov 6.
AIM
To evaluate the relationship between the imaging features of combined hepatocellular-cholangiocarcinoma (CHC) on contrast-enhanced ultrasound (CEUS) and clinicopathological findings.
MATERIALS AND METHODS
From August 2004 to August 2016, 40 patients (29 males, 11 females; mean age 52.8±11.2 years) with histopathologically proven CHC were investigated. The CEUS imaging features and clinicopathological findings of CHC were analysed and compared retrospectively.
RESULTS
On CEUS, peripheral irregular rim-like enhancement, diffuse heterogeneous enhancement, and diffuse homogeneous enhancement was illustrated in 13 (32.5%), 21 (52.5%), and six (15%) lesions, respectively. Histopathological findings showed hepatocellular carcinoma (HCC) predominance and cholangiocarcinoma (CC) predominance throughout the tumour were illustrated in 21 (52.5%) and 19 (47.5%) cases, respectively. HCC-predominant CHCs displayed diffuse heterogeneous enhancement more frequently than peripheral irregular rim-like enhancement (p=0.005), whereas CC-predominant CHCs displayed peripheral irregular rim-like enhancement more frequently than diffuse heterogeneous enhancement and homogeneous enhancement (p=0.005 and p=0.01, respectively). CHCs >5 cm displayed diffuse heterogeneous enhancement more frequently than diffuse homogeneous enhancement, whereas CHCs ≤5 cm displayed diffuse homogeneous enhancement more frequently than diffuse heterogeneous enhancement (p=0.004).
CONCLUSION
The enhancement pattern of CHC on CEUS depended on the relative proportions of the HCC and CC components and showed size-dependent characteristics.
目的
评估肝细胞-胆管细胞癌（CHC）在超声造影（CEUS）下的影像学特征与临床病理结果之间的关系。
材料与方法
对2004年8月至2016年8月期间40例经组织病理学证实为CHC的患者（男性29例，女性11例；平均年龄52.8±11.2岁）进行研究。回顾性分析并比较CHC的CEUS影像学特征和临床病理结果。
结果
在CEUS上，13个（32.5%）、21个（52.5%）和6个（15%）病灶分别表现为周边不规则环状强化、弥漫性不均匀强化和弥漫性均匀强化。组织病理学结果显示，肿瘤整体以肝细胞癌（HCC）为主和以胆管细胞癌（CC）为主的病例分别为21例（52.5%）和19例（47.5%）。以HCC为主的CHC表现为弥漫性不均匀强化的频率高于周边不规则环状强化（p=0.005），而以CC为主的CHC表现为周边不规则环状强化的频率高于弥漫性不均匀强化和均匀强化（分别为p=0.005和p=0.01）。直径>5 cm的CHC表现为弥漫性不均匀强化的频率高于弥漫性均匀强化，而直径≤5 cm的CHC表现为弥漫性均匀强化的频率高于弥漫性不均匀强化（p=0.004）。
结论
CHC在CEUS上的强化模式取决于HCC和CC成分的相对比例，并呈现出大小依赖性特征。
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