超声造影诊断肝细胞癌自发性坏死：附2例报告
Contrast-enhanced ultrasonography for the diagnosis of spontaneous necrosis of hepatocellular carcinoma: A report of 2 cases.
作者信息
Ota Yu, Aso Kazunobu, Otake Shin, Okada Mitsuyoshi, Shukuda Kounosuke, Sawada Koji, Yokoo Hideki, Tanino Mishie, Fujiya Mikihiro, Okumura Toshikatsu
机构信息
Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan.
Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan.
出版信息
Radiol Case Rep. 2022 Nov 1;18(1):173-181. doi: 10.1016/j.radcr.2022.10.019. eCollection 2023 Jan.
Spontaneous necrosis of hepatocellular carcinoma (HCC) is rare and difficult to diagnose preoperatively if it occurs before the definitive diagnosis of HCC; this is because spontaneous necrosis of HCC exhibits various patterns in imaging studies. We compared imaging and pathological findings, and examined the possibility of diagnosing spontaneous necrosis of HCC using contrast-enhanced ultrasonography (CEUS). We experienced 2 cases of spontaneous necrosis of HCC. In case 1, spontaneous necrosis occurred after HCC diagnosis, while in case 2 it occurred before the first admission. The tumor in case 2 contained internal nodules and outer fibrous tissue. CEUS revealed a vascular spot in the hypovascular area during the vascular phase and a complete defect during the Kupffer phase. These findings accorded with the pathological findings and may be important for diagnosing spontaneous necrosis of HCC.
肝细胞癌（HCC）的自发性坏死较为罕见，若在HCC确诊前发生，则术前难以诊断；这是因为HCC的自发性坏死在影像学检查中表现出多种形态。我们比较了影像学和病理结果，并探讨了使用超声造影（CEUS）诊断HCC自发性坏死的可能性。我们遇到了2例HCC自发性坏死的病例。病例1中，自发性坏死发生在HCC诊断之后，而病例2则发生在首次入院之前。病例2的肿瘤包含内部结节和外部纤维组织。CEUS显示，在动脉期，低血供区域有血管点，在肝血池期有完全缺损。这些结果与病理结果相符，可能对诊断HCC自发性坏死具有重要意义。
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