在超声检查其他方面均正常的肝脏中发生的肝细胞癌。
Hepatocellular carcinoma in otherwise sonographically normal liver.
作者信息
Naganuma Hiroko, Ishida Hideaki, Ogawa Masahiro, Sato Tutomu, Sageshima Masato, Suzuki Katunori, Ohyama Yoko
机构信息
Department of Gastroenterology, Yokote Municipal Hospital, Yokote, Akita Prefecture, Japan.
Department of Gastroenterology, Akita Red Cross Hospital, Akita, Akita Prefecture, Japan.
出版信息
J Clin Ultrasound. 2019 Jul;47(6):325-330. doi: 10.1002/jcu.22677. Epub 2018 Nov 28.
PURPOSE
Hepatocellular carcinoma (HCC) on normal liver is very rare. The goal of this study was to determine the clinical manifestations and the role of ultrasonography (US) in the diagnosis of HCC arising in normal liver.
METHODS
The clinical data and US findings in 12 cases of surgically resected HCC in normal liver were retrospectively analyzed.
RESULTS
The patients were asymptomatic, had no hepatocarcinogenic factor, and hepatic function tests were almost normal in most cases. HCCs were large, encapsulated, and solitary, and there were predominantly well-differentiated or moderately differentiated in most cases. US showed a hypoechoic rim and lateral shadowing, suggestive of peritumoral capsule formation, and on contrast-enhanced US (CEUS), the tumor was hyperenhanced in arterial phase and washed out in postvascular phase, revealing typical HCC findings.
CONCLUSIONS
US raises suspicion of HCC by showing lateral shadowing on grayscale ultrasound and hypervascularity on CEUS of the lesion.
目的
正常肝脏发生的肝细胞癌（HCC）非常罕见。本研究的目的是确定正常肝脏中发生的HCC的临床表现以及超声检查（US）在其诊断中的作用。
方法
回顾性分析12例正常肝脏中手术切除的HCC的临床资料和超声检查结果。
结果
患者无症状，无致癌因素，大多数病例肝功能检查基本正常。HCC体积较大，有包膜，为单发，大多数病例主要为高分化或中分化。超声显示低回声边缘和侧方声影，提示肿瘤周围包膜形成，在超声造影（CEUS）中，肿瘤在动脉期呈高增强，在血管后期消退，显示典型的HCC表现。
结论
超声通过在灰阶超声上显示侧方声影以及在病变的CEUS上显示血管增多来提高对HCC的怀疑。
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