Teefey S A, Stephens D H, James E M, Charboneau J W, Sheedy P F
Clin Radiol. 1986 Jul;37(4):339-45. doi: 10.1016/s0009-9260(86)80266-5.
Computed tomography (CT) scans and sonograms of 37 patients with hepatocellular carcinoma (hepatoma) were reviewed to determine the characteristics of the tumour and to compare the modalities in terms of accuracy in defining tumour morphology and ability to predict vascular invasion and extrahepatic spread. By CT, slightly over 50% of the tumours were multicentric, about 40% were solitary, and the rest were diffuse. About half of the hepatomas were heterogeneous in density before injection of contrast agent and most became enhanced in a non-uniform manner. In addition, about a quarter of the tumours either became visible or were better seen after injection of contrast agent. At sonography, approximately two-thirds of the neoplasms were thought to be solitary and one-third multicentric. The majority also had a mixed echo texture. Although the lesion was identified in all 13 patients who had both studies, sonography underestimated the extent of hepatic involvement in 38% of the cases. Sonography also failed to demonstrate lymphadenopathy that was detected by CT in two patients. In general, both techniques were effective in identifying vascular invasion. CT was very accurate in showing the extent of hepatic involvement but was unable to identify direct invasion of neighbouring structures. Because each technique has limitations in the evaluation of hepatoma, we believe that both should be performed if curative resection is being considered.
对37例肝细胞癌（肝癌）患者的计算机断层扫描（CT）和超声检查结果进行了回顾，以确定肿瘤的特征，并比较这两种检查方式在定义肿瘤形态以及预测血管侵犯和肝外转移方面的准确性。通过CT检查，略超过50%的肿瘤为多中心性，约40%为单发性，其余为弥漫性。约一半的肝癌在注射造影剂前密度不均匀，大多数呈不均匀强化。此外，约四分之一的肿瘤在注射造影剂后变得可见或显示得更清楚。在超声检查中，约三分之二的肿瘤被认为是单发性的，三分之一是多中心性的。大多数肿瘤也具有混合回声特征。虽然在同时进行这两种检查的13例患者中均发现了病变，但超声检查在38%的病例中低估了肝脏受累的范围。超声检查还未能显示出CT检查在两名患者中发现的淋巴结病变。总体而言，两种技术在识别血管侵犯方面都很有效。CT在显示肝脏受累范围方面非常准确，但无法识别对邻近结构的直接侵犯。由于每种技术在肝癌评估中都有局限性，我们认为如果考虑进行根治性切除，两种检查都应该进行。
