原发性肝脏透明细胞癌的MSCT影像表现分析

Multislice Spiral CT Imaging Features of Primary Clear Cell Carcinoma of the Liver

目的探讨原发性肝脏透明细胞癌(primary clear cell carcinoma of the liver,PCCCL)的多层螺旋CT(MSCT)表现。资料与方法回顾性分析经手术病理证实的8例PCCCL患者的临床及MSCT资料。结果 8例均有乙肝病史,其中男性患者7例,甲胎蛋白(AFP)阴性6例。8例均为单发病灶,6枚病灶发生于肝右叶,多呈圆形、椭圆形或浅分叶,无包膜,边界不清,以实性成分为主,瘤内可见坏死区。CT平扫示肿瘤实性部分呈低密度或等密度。CT双期增强扫描,5枚病灶呈轻度强化,以病灶的边缘区强化明显,1枚病灶呈斑片状不均匀强化;2枚病灶呈典型普通型肝细胞癌的"速升速降"强化方式;1枚病灶呈明显强化,门静脉期强化程度高于动脉期;病灶中心的坏死区均不强化。结论 PCCCLMSCT影像学表现,结合相关的临床资料,对该病的诊断有一定提示作用,确诊依赖病理。

Objective To explore the MSCT findings of primary clear cell hepatocellular carcinoma.Materials and Methods The clinic data and MSCT findings of 8 cases with primary clear cell hepatocellular carcinoma proved by pathological results were analyzed retrospectively.Results All 8 cases （7 males and 1 females） had a history of hepatitis B.The AFP indicators of 6 cases were negative.6 cases were located in right lobe.All the cases had single lesion without capsule,the boundary of tumors was not clear,the shape of tumor was round,oval,or shallow lobulated.The tumors mostly were presented as necrotic mass with a central non-enhanced zone.The solid part of mass showed isodense or hypodense on CT non-contrast enhanced scan.Mild contrast enhancement was found in 5 cases,and the edge of the lesion area was absolutely significantly enhanced;2 cases showed the typical enhanced CT findings of HCC;markedly enhancement was found in 1 case,and the mass showed more enhancement in the portal venous phase than that in the arterial phase;central necrosis in the mass showed no contrast enhancement.Conclusion Although the MSCT features and the clinic data are useful for the diagnosis of the primary clear cell hepatocellular carcinoma,the final diagnosis is depended on pathology.