肝样腺癌CT及MRI表现

CT and MRI manifestations of hepatoid adenocarcinoma

目的 观察肝样腺癌(HAC)CT及MRI表现。方法 收集10例经手术(n=9)或穿刺活检(n=1)病理证实的HAC患者,其中9例接受CT平扫及增强检查,1例直肠HAC接受平扫及增强MR检查,观察其影像学表现。结果 10例HAC中,5例位于消化道(胃3例、食管1例、直肠1例),2例位于前纵隔,位于胸壁及腹壁皮肤、胆囊及卵巢各1例;9例为单发病灶,1例(序号8)2个病灶分别位于胸壁及腹壁皮肤;5个消化道病灶表现为胃壁、食管壁或肠壁不均匀增厚,边界不清;6个前纵隔、胸壁及腹壁皮肤、胆囊或卵巢HAC均表现为软组织密度病灶,5个边界较清、1个边界不清。CT/MR增强后7个病灶呈轻度不均匀强化,3个呈不均匀延迟强化,1个呈不均匀明显强化。结论 HAC的CT及MRI表现具有一定特征性。

Objective To observe CT and MRI manifestations of hepatoid adenocarcinoma(HAC).Methods Ten patients with HAC confirmed by operation(n=9)or puncture biopsy(n=1)pathology were enrolled.Nine patients underwent plain and enhanced CT scanning,while 1 patient(rectal HAC)underwent plain and enhanced MR scanning.Then imaging manifestations of HAC were analyzed.Results Among 10 cases of HAC,the lesions located in digestive tract in 5 cases,including 3 cases in stomach,1 cases in esophagus and 1 case in rectum,while in anterior mediastinum in 2 cases,and in each 1 case in chest and abdominal wall skin,gallbladder and ovary,respectively.Single HAC lesion was detected in 9 cases,while 1 case(No.8)was found with 2 lesions located in chest and abdominal wall skin.Totally 5 lesions located in digestive tract present as esophagus,stomach or intestinal wall unevenly thickened with unclear boundaries,and 6 lesions in anterior mediastinum,chest and abdominal wall,gallbladder and ovary HAC(6 lesions in total)showed soft tissue density,5 with clear boundaries and 1 with unclear boundary.On enhanced CT/MR scanning,mild uneven enhancement was found in 7 lesions,while uneven delayed enhancement and uneven significantly enhanced was noticed in 3 and 1 lesion,respectively.Conclusion CT and MRI manifestations of HAC had certain characteristics.