Department of Radiology, Research Institute of Radiological Science, Center for Clinical Imaging Data Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
Korean J Radiol. 2024 Oct;25(10):887-901. doi: 10.3348/kjr.2024.0307.
Hepatocellular carcinoma (HCC) progresses through multiple stages of hepatocarcinogenesis, with each stage characterized by specific changes in vascular supply, drainage, and microvascular structure. These vascular changes significantly influence the imaging findings of HCC, enabling non-invasive diagnosis. Vascular changes in HCC are closely related to aggressive histological characteristics and treatment responses. Venous drainage from the tumor toward the portal vein in the surrounding liver facilitates vascular invasion, and the unique microvascular pattern of vessels that encapsulate the tumor cluster (known as a VETC pattern) promotes vascular invasion and metastasis. Systemic treatments for HCC, which are increasingly being used, primarily target angiogenesis and immune checkpoint pathways, which are closely intertwined. By understanding the complex relationship between histopathological vascular changes in hepatocarcinogenesis and their implications for imaging findings, radiologists can enhance the accuracy of imaging diagnosis and improve the prediction of prognosis and treatment response. This, in turn, will ultimately lead to better patient care.
肝细胞癌 (HCC) 经过多个肝癌发生阶段进展，每个阶段的特征为血管供应、引流和微血管结构的特定变化。这些血管变化显著影响 HCC 的影像学表现，使非侵入性诊断成为可能。HCC 的血管变化与侵袭性组织学特征和治疗反应密切相关。肿瘤向周围肝脏门静脉的静脉引流促进了血管侵犯，而包裹肿瘤簇的独特微血管模式（称为 VETC 模式）促进了血管侵犯和转移。HCC 越来越多地使用的系统治疗主要针对血管生成和免疫检查点途径，这两者密切相关。通过了解肝癌发生过程中组织病理学血管变化的复杂关系及其对影像学发现的影响，放射科医生可以提高影像学诊断的准确性，并改善对预后和治疗反应的预测。这反过来将最终为患者带来更好的治疗效果。
