CAJ | 학술논문

目的探讨原发性肝脏透明细胞癌(primary clear cell carcinoma of liver,PCCCL)的影像学特征及其临床应用价值.方法回顾性分析12例经手术病理证实的PCCCL的MRI及CT检查资料.其中行MRI平扫及增强扫描8例,行CT平扫及增强扫描10例.结果病灶67％(8/12)位于肝右叶,25％(3/12)位于左叶,8％(1/12)位于尾叶,瘤径1.6～9.8 cm,平均3.6 cm.MRI检查75％(6/8)呈T2WI混杂高信号,T1WI同相位等或稍低信号,反相位信号均减低,其中67％ (4/6)明显减低,DWI均呈高信号；增强动脉期75％(4/6)轻度强化,门脉期持续轻度强化,病理证实透明细胞比例较高.25％(2/8)呈T2WI等信号,T1WI同相位稍高信号,反相位信号均减低,DWI呈等或稍高信号；增强动脉期明显强化,门静脉期廓清,透明细胞比例相对较低.50％(4/8)见环形强化的包膜.CT平扫均为低密度,增强动脉期80％ (8/10)轻度强化,门脉期持续强化,病理证实75％(6/8)透明细胞比例较高,25％(2/8)透明细胞比例相对较低.20％(2/10)动脉期不均匀明显强化,门脉期强化程度明显下降,透明细胞比例较低.20％(2/10)显示延迟强化的包膜.结论 MRI和CT平扫及动态增强扫描能全面、准确显示PCCCL的病理特征及组织构成,具有一定的特征,是目前诊断PCCCL的有效方法.二者结合对PCCCL的术前诊断具有重要价值,可为临床制定最佳治疗方案及预后评估提供重要信息.
목적 탐토원발성간장투명세포암(primary clear cell carcinoma of liver,PCCCL)적영상학특정급기림상응용개치.방법 회고성분석12례경수술병리증실적PCCCL적MRI급CT검사자료.기중행MRI평소급증강소묘8례,행CT평소급증강소묘10례.결과 병조67％(8/12)위우간우협,25％(3/12)위우좌협,8％(1/12)위우미협,류경1.6～9.8 cm,평균3.6 cm.MRI검사75％(6/8)정T2WI혼잡고신호,T1WI동상위등혹초저신호,반상위신호균감저,기중67％ (4/6)명현감저,DWI균정고신호；증강동맥기75％(4/6)경도강화,문맥기지속경도강화,병리증실투명세포비례교고.25％(2/8)정T2WI등신호,T1WI동상위초고신호,반상위신호균감저,DWI정등혹초고신호；증강동맥기명현강화,문정맥기곽청,투명세포비례상대교저.50％(4/8)견배형강화적포막.CT평소균위저밀도,증강동맥기80％ (8/10)경도강화,문맥기지속강화,병리증실75％(6/8)투명세포비례교고,25％(2/8)투명세포비례상대교저.20％(2/10)동맥기불균균명현강화,문맥기강화정도명현하강,투명세포비례교저.20％(2/10)현시연지강화적포막.결론 MRI화CT평소급동태증강소묘능전면、준학현시PCCCL적병리특정급조직구성,구유일정적특정,시목전진단PCCCL적유효방법.이자결합대PCCCL적술전진단구유중요개치,가위림상제정최가치료방안급예후평고제공중요신식.
Objective To investigate the imaging features of primary clear cell carcinoma of the liver (PCCCL) and its clinical value.Methods MRI and CT finding of 12 patients with PCCCL proved by pathology were analyzed retrospectively.8 patients underwent plain and dynamically enhanced MRI and 10 patients underwent plain and dynamically enhanced CT scanning.Results The numbers were 67％ (8/12) in the right lobe,25％ (3/12) in the left lobe,and 8％(1/12) in the caudate lobe.Tumor diameters were 1.6 to 9.8 cm,and the average was 3.6 cm.For the MRI examination,75 ％ (6/8) showed a mixed high signal on T2WI and an equal or slightly lower signal on T1WI.All of the signal was reduced on anti-phase T1WI,67 ％ (4/6)was obviously reduced,and all showed high signal on DWI.The 75 ％ (4/6) slightly enhanced at the arterial phase continued to enhance at the portal venous phase.The pathology confirmed that there was a higher proportion of clear cell.25 ％ (2/8) showed an equal signal on T2WI and a slightly higher signal on T1WI,all of the signal reduced on anti-phase T1WI,and all showed equal or slightly higher signal on DWI.All were significantly enhanced at the arterial phase and clearanced at the portal venous phase.The pathology confirmed that there was a relative lower proportion of clear cell.50％ (4/8) could be seen with the capsule and ring enhanced.All showed low-density on CT scan,80％ (8/10) were slightly enhanced at arterial phase and the signals continued to strengthen at the portal venous phase.The pathology confirmed that 75％ (6/8) had a higher proportion of clear cell and 25％ (2/8) had a relatively low proportion of clear cell.20％ (2/10) showed significantly uneven enhancement at the arterial phase and the degree of enhancement decreased at the portal venous phase.The pathology confirmed that there was a lower proportion of clear cell.20％ (2/10) could be seen with the capsule with the ring enhanced.Conclusions Plain and dynamically enhanced MRI and CT scans could show the pathological features and tissue composition of PCCCL fully and accurately.They were effective methods and each had certain characteristics.The combination of these had important values to diagnosis PCCCL and could provide important information for clinics to develop the best treatment plan and prognostic evaluation.