原发性肝癌超声鉴别诊断的病理基础

The pathological basis for differential diagnosis of hepatocellular carcinoma with ultrasound

目的 探讨形成肝癌超声不同回声的组织病理学基础。方法 经超声引导对肝脏 186个实性不同回声病灶行穿刺组织学活检 ,分析与灰阶声像图相对应的组织病理改变。结果 90例肝癌中低回声者组织结构致密 ,细胞成分简单 ,声像图上有低回声暗环者有包膜。当癌组织内有大片脂肪变性、透明细胞或非液化性不均匀性坏死时 ,声像图上显示为高回声。除肝癌外的肝内实性占位病变具有上述组织病理改变时 ,可形成与肝癌相似的声像图回声。结论 肝癌声像图上的不同回声是其组织病理改变的声学表现。

Objective To evaluate the pathologic basis which affects the echo patterns of hepatocellular carcinoma(HCC).Methods One hundred and eighty six nodules with typical hyperechoic or hypoechoic regions were biopsied guided by ultrasound. The relationship between the echo pattern of ultrasound image and corresponding pathological changes was analyzed. Results Of 90 lesions of HCC, the nodules with low echo were fine and close in texture and their component relatively was simple and had dense cellular nucleus. The nodules with hypoechoic dark ring at the periphery and lateral posterior shadow had fibrous capsules. The nodules appeared high echo when they had fatty denature, clear cell or unhomogenous coagulation necrosis. The solid lesions of liver besides HCC appeared similar echo pattern to HCC if only they had similar histopathological structure. Conclusions The changes of echo patterns in HCC is the acoustic appearance of histopathology. The sonographic characteristics of HCC depends on its histopathological structure.