Murakami R, Korogi Y, Sakamoto Y, Takhashi M, Okuda T, Yasunaga T, Nishimura R, Yoshimatsu S
Department of Radiology, Kumamoto University School of Medicine, Japan.
Acta Radiol. 1995 Nov;36(6):597-602.
CT, MR and angiographic findings of 6 patients with 9 skull metastases from hepatocellular carcinoma (HCC) were reviewed. In 3 of 6 patients, local pain or neurologic deficit was the initial main manifestation of the disease, although all had been treated for chronic liver disease. In the remaining 3 patients, skull metastases were detected following treatment of HCC. The metastatic lesions appeared as expansile osteolytic masses on CT and as hypervascular masses on angiography. All lesions were demonstrated on MR imaging. Compared with the brain parenchyma, the lesions were iso- or hypointense on T1-weighted and T2-weighted MR images. The lesions were moderately to markedly enhanced by Gd-DTPA. Flow voids were shown in the tumors in 5 lesions. HCC should be included in the differential diagnosis of an osteolytic hypervascular lesion of the skull, especially in Oriental patients. The relatively hypointense tumor on T2-weighted MR images associated with flow void, different from primary skull tumors or directly invasive tumors, may support the diagnosis of HCC metastasis.
回顾了6例肝细胞癌（HCC）发生9处颅骨转移患者的CT、MR及血管造影表现。6例患者中有3例，尽管均已接受慢性肝病治疗，但局部疼痛或神经功能缺损是疾病的初始主要表现。其余3例患者在HCC治疗后发现颅骨转移。转移灶在CT上表现为膨胀性溶骨性肿块，血管造影显示为高血运肿块。所有病灶在MR成像上均能显示。与脑实质相比，病灶在T1加权和T2加权MR图像上呈等信号或低信号。病灶经钆喷酸葡胺（Gd-DTPA）呈中度至明显强化。5处病灶的肿瘤内可见流空信号。颅骨溶骨性高血运病变的鉴别诊断应包括HCC，尤其是在东方患者中。T2加权MR图像上相对低信号的肿瘤伴有流空信号，不同于原发性颅骨肿瘤或直接浸润性肿瘤，可能支持HCC转移的诊断。
