原发性肝脏透明细胞癌MRI诊断分析

MRI Diagnosis of Primary Clear Cell Carcinoma of Liver

目的探讨原发性肝脏透明细胞癌(PCCCL)的MRI表现,为临床准确诊断PCCCL提供参考依据。方法选取本院2014年6月~2017年3月间经手术病理证实且行上腹部MR平扫及强化扫描的PCCCL患者19例,并对MR图像进行回顾性分析。结果 19例PCCCL病灶均为单发,病灶位于右叶者15例,左叶者4例,病灶直径范围1.5~13.4(4.2±0.6)cm。病灶形态呈类圆形10例,具有分叶的病灶8例,形态不规则1例,边界清晰的病灶15例,边界欠清晰4例。16例患者病灶T1WI呈稍高信号,3例T1WI呈稍低信号,10例T2WI呈稍高信号,9例T2WI呈高信号,19例病灶T1WI及T2WI内信号均不均匀,T1WI反向位所有病灶信号较正相位均有不同程度减低,5例DWI呈等信号,14例DWI呈稍高信号。17例病灶增强动脉期呈轻-中度强化,门静脉期及延迟期呈相对低信号,2例呈现持续性轻度强化。所有患者门静脉内均未见癌栓形成。结论PCCCL的MRI表现具有一定特征,可为临床准确诊断PCCCL提供重要参考依据。

Objective To discuss MRI features of primary clear cell carcinoma of liver（ PCCCL）. Methods MRI findings of 19 cases with PCCCL proved by pathology in our hospital from June 2014 to March 2017 were analyzed retrospectively. All patients underwent Non-contrast and dynamic contrast MR sanning. Results All the lesions were solitary and the lesions were located in right hepatic lobe（ n =15） or in left hepatic lobe（ n = 4） with diameter ranging from 1. 5 to 13. 4（ 4. 2 ± 0. 6） cm. The shape of lesions was oval（ n = 10）,lobulated（ n = 8） or Irregular（ n = 1）. The boundary of lesions were clear（ n = 15） or not clear（ n = 4）. Sixteen lesions showed slightly higher signal in T1 WI while 3 lesions showed slightly lower signal in T1 WI. 10 lesions showed slightly higher signal and 9 lesions showed high signal in T2 WI,both in T1 WI and T2 WI,all the lesions showed inhomogeneous signal. All of the signal was reduced in T1 WI opposed phase,5 lesions showed equal signal and 14 lesions showed slightly higher signal in DWI. In contrast-enhanced MRI scanning,the 17 lesions presented as mild-to-moderate enhancement in arterial phase,relatively lower signals in portal phase and delayed phase and 2 lesions presented as persistent mild enhancement. Ring-like pseudocapsule enhancement was observed in 10 lesions. Conclusion MRI findings of PCCCL have certain characteristics,w HS2 hich provide clinical basis for accurate diagnosis of PCCCL.