CAJ | 학술논문

目的：探讨肝细胞癌(hepatocel ular carcinoma,HCC)并胆管癌栓的 CT 表现特点,提高诊断率。方法：回顾性分析8例经手术证实为 HCC 并胆管癌栓患者的CT 表现特点。结果：男性6例,女性2例,术前 CT 检查发现肝脏肿瘤,发现胆管癌栓7例,表现为胆管内稍低或等密度软组织影,增强扫描3例呈“早进早退”的典型肝细胞癌强化特征,3例中等度强化,2例轻度强化；胆管壁无增厚或受侵表现；梗阻远端胆管膨胀性扩张,表现为树枝状低密度影及多发小圆形低密度影；结合病理分析认为“早进早退”的癌栓为肝内肿块直接浸润胆管所致癌栓,轻度强化的癌栓成分以癌细胞为主,不强化的癌栓以坏死组织或血栓为主内含癌细胞。结论：肝细胞肝癌并胆管癌栓 CT 表现有一定的特征,术前检查可帮助明确诊断,并区分黄疸型肝癌的黄疸原因,对提高术前综合判断、指导制定及实行针对性手术计划具有重要的意义。
목적：탐토간세포암(hepatocel ular carcinoma,HCC)병담관암전적 CT 표현특점,제고진단솔。방법：회고성분석8례경수술증실위 HCC 병담관암전환자적CT 표현특점。결과：남성6례,녀성2례,술전 CT 검사발현간장종류,발현담관암전7례,표현위담관내초저혹등밀도연조직영,증강소묘3례정“조진조퇴”적전형간세포암강화특정,3례중등도강화,2례경도강화；담관벽무증후혹수침표현；경조원단담관팽창성확장,표현위수지상저밀도영급다발소원형저밀도영；결합병리분석인위“조진조퇴”적암전위간내종괴직접침윤담관소치암전,경도강화적암전성분이암세포위주,불강화적암전이배사조직혹혈전위주내함암세포。결론：간세포간암병담관암전 CT 표현유일정적특정,술전검사가방조명학진단,병구분황달형간암적황달원인,대제고술전종합판단、지도제정급실행침대성수술계화구유중요적의의。
Objective:To investigate the liver cellcarcinoma (hepatocellular carcinoma,HCC)and CT features of tumor thrombi in the bile duct,improve the rate of diG agnosis.Methods:A retrospective analysis of 8 cases were confirmed by operation for the HCC and CT features of patients with tumor thrombi in the bile duct.Result:6 caG ses of male,female 2 cases,preoperative CT examination showed that liver tumor,tumor thrombi in the bile duct in 7 cases,bile duct showed slightly low or the shadow of soft tissue density,enhanced scan in 3 cases showed typical"hepatocellular carcinoma early into the early"enhanced features,3 cases of moderate enhancement,2 cases mild to strong;bile duct wal without thickening or invasion;obstruction distal bile duct expansion expansion,showed dendritic low density and smal circular low density;comG bined with pathological analysis "cancer embolus back into early" for intrahepatic bile duct cancer thrombus mass direct infiltration of tumor thrombus composition,mild enhancement in cancer cells,cancer embolus is not enhanced by necrosis tissue or thrombus containing cancer cells.Conclusion:Hepatocellular carcinoma with bile duct thrombi certain CT features,preoperative examination can help the diagnosis and distinguishing jaundice,icteric type hepatocellular carcinoma,to improve the preoperative comprehensive judgment,guide the formulation and implementation of the plan of operation has important significance.