Tsukahara Yoshinori, Okajima Yukinori, Yamada Akira, Momose Masanobu, Uehara Takeshi, Shimizu Akira, Soejima Yuji, Fujinaga Yasunari
Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
Department of Laboratory Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
World J Surg Oncol. 2021 Feb 6;19(1):41. doi: 10.1186/s12957-021-02152-2.
A peritumoral hypointense rim (PTHR) is sometimes observed around hepatocellular carcinoma (HCC) on T2*-weighted images (T2WIs). We aimed to investigate the association between the PTHR and histopathologic findings on T2WIs.
We assessed the presence of a PTHR on T2WIs in 39 pathologically proven HCCs from April 2012 to December 2013. Prussian blue staining was performed, and iron deposition was evaluated by semiquantitative and quantitative methods. Optical density was used in the quantitative methods. The associations between a PTHR on T2WI and histopathologic peritumoral or background liver iron deposition were analyzed.
A PTHR on T2*WI was observed in 23 of 39 (59%) HCCs. There was no significant difference in the histopathologic fibrous capsule findings (P = 0.394). In the semiquantitative methods, both peritumoral and background liver iron deposition grade were significantly higher in HCCs with a PTHR compared with HCCs without a PTHR (P < 0.001). The mean optical density in HCCs with a PTHR was significantly higher compared with HCCs without a PTHR, in the quantitative peritumoral (42,244.1 ± 20,854.9 vs. 18,739.1 ± 12,258.7, respectively; P < 0.001) and background liver iron deposition analyses (35,554.7 ± 19,854.8 vs. 17,292.4 ± 11,605.8, respectively; P < 0.001). Tumor size (P = 0.005), etiology (P = 0.001), and degree of fibrosis (P = 0.042) were significantly associated with the presence of a PTHR.
A PTHR in HCCs on T2*WIs was strongly associated with peritumoral iron deposition in the iron-deposited background liver but not with the fibrous capsule.
在T2加权成像（T2WI）上，有时可在肝细胞癌（HCC）周围观察到瘤周低信号环（PTHR）。我们旨在研究T2*WI上的PTHR与组织病理学表现之间的关联。
我们评估了2012年4月至2013年12月期间39例经病理证实的HCC在T2WI上PTHR的存在情况。进行普鲁士蓝染色，并通过半定量和定量方法评估铁沉积。定量方法中使用光密度。分析了T2WI上的PTHR与组织病理学瘤周或肝实质背景铁沉积之间的关联。
39例HCC中有23例（59%）在T2*WI上观察到PTHR。组织病理学纤维包膜表现无显著差异（P = 0.394）。在半定量方法中，与无PTHR的HCC相比，有PTHR的HCC瘤周和肝实质背景铁沉积分级均显著更高（P < 0.001）。在定量瘤周铁沉积分析（分别为42,244.1 ± 20,854.9和18,739.1 ± 12,258.7；P < 0.001）和肝实质背景铁沉积分析（分别为35,554.7 ± 19,854.8和17,292.4 ± 11,605.8；P < 0.001）中，有PTHR的HCC的平均光密度显著高于无PTHR的HCC。肿瘤大小（P = 0.005）、病因（P = 0.001）和纤维化程度（P = 0.042）与PTHR的存在显著相关。
HCC在T2*WI上的PTHR与铁沉积背景肝中的瘤周铁沉积密切相关，但与纤维包膜无关。
