原发性肝脏透明细胞癌的CT影像表现

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 of liver,PCCCI,)的CT影像学表现及特征,为术前诊断提供参考。方法回顾性分析经手术证实的6例PCCCL的CT表现及临床资料,3例行平扫及动态增强扫描,3例行动态增强扫描。结果 男性2人,女性4人,5人有乙肝病史,AFP阳性2例。病灶数6个,83%(5/6)位于肝右叶,17%(1/6)位于左内叶。50%(3/6)病灶边界不清,动脉期增强扫描病变均呈轻度不均匀强化,门静脉期及延迟期多呈轻度持续性强化,1例等一低混杂密度病变呈持续性渐进性强化,并见假包膜。结论 PCCCL的CT动态增强呈持续性不均匀强化,三期扫描均低于正常肝实质,具有较特征性影像学表现,能够为术前诊断提供重要诊断价值。

Objective To investigate CT appearance of primary clear cell carcinoma of the liver (PCCCL) so as to confirming the diagnosis for the patients with primary clear cell carcinoma of the liver before operation. Methods The clinical data and CT appearance on 6 patients with PCCCL proved with pathology after surgery were retrospectively analyzed. All 6 patients with PCCCL underwent dynamic contrast CT scan and 3 patients with PCCCL did plain CT.Results Of 6 patients with PCCCL, 2 were male and 4 female. Five patients with PCCCL suffered from chronic hepatitis B. The serum concentration of fetoprotein was positive in 2 cases. The lesion were 6 in patients with PCCCL and The lesion were located in right lobe in 5 cases (83%) and the esion were located in left inside lobe in 1 cases (17%). On plain CT, 5 lesions showed hypodense, 1 showed hypodensity or hyperdensity. The boundary of 50% (3/6) cases was unclear. On dynamic contrast scan, 3 lesions showed slightly enhancement on hepatic arterial phase, and persistent enhancement on venous and equilibrium phase. Pseudocapsule was seen in 1 case, which showed continuous enhancement.Conclusion The continuous and heterogeneous enhancement is useful for the diagnosis of PCCCL. In contrast with normal hepatic tissue, PCCCL always shows hypodense during the three phases on dynamic contrast scan and has more characteristic imaging features, and can provide important diagnostic value for preoperative diagnosis.