| 蒋涛,刘光华,李慎江.肝癌边缘CT征象与组织病理学的相关性[J].中国医学影像技术,2005,21(2):272~275 |
| 肝癌边缘CT征象与组织病理学的相关性 |
| CT-pathology correlation on peripheral of hepatocellular carcinoma |
| 投稿时间：2004-08-18 修订日期：2005-01-07 |
| DOI： |
| 中文关键词: 癌,肝细胞 体层摄影术,X线计算机 病理学 |
| 英文关键词:Carcinoma, hepatocellular Tomography, X-ray computed Pathology |
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| 中文摘要: |
| 目的 利用肝移植手术标本探讨肝细胞肝癌(HCC)边缘部CT征象的组织病理学基础。方法 42例经肝移植手术证实的HCC,术前全肝平扫后,分别于开始注射造影剂后25 s、60 s行全肝螺旋CT动、门脉双期扫描。观察新鲜手术标本后,常规HE染色和Ⅷ因子相关抗原单克隆抗体免疫组化染色,观察肿瘤边缘部的CT表现及各种病理改变。结果 CT平扫病灶边缘清楚,病理上肿瘤多有包膜;而边缘不清的病理上肿瘤浸润性生长多见;动态增强后肿瘤边缘不清或呈高密度者,边缘多可见丰富的新生血管,肿瘤分化较低,而呈低密度者新生血管较少,分化程度较高;肿瘤边缘微血管密度(MVD)>30时,发生肝内子灶的几率要高。结论 HCC边缘部的CT形态分类,能较好地反映肿瘤包膜的完整程度,有助于术前评估肿瘤的浸润范围及评价癌细胞的分级; CT动、门脉双期扫描,癌灶边缘强化特征可反映其组织病理学改变,并能在一定程度上预测其预后。 |
| 英文摘要: |
| Objective To study the pathologic bases of CT findings of the peripheral of HCC lesions. Methods Forty-two patients with HCC confirmed by liver transplantation were included. An unenhanced scanning covering the whole liver was done, and followed by arterial and portal venous phase scanning. The delay time was 25 s and 60 s after the injection of contrast media. After evaluation of the fresh samples and the slides stained with HE and the standard immunoperoxidase method using the monoclonal antibody of facterⅧ related antigen (F8RA), the CT patterns of the peripheral of tumor and the pathological changes were studied. Results On CT scan, clear boundary could reflect the capsule of tumor on pathology. Blurred boundary often showed that few lesions had capsules and the growth pattern was invasive. After enhancement, the peripheral of HCC demonstrated as blurred or hyper-attenuation showed rich neovascular structure, low tumor differentiation.While poor neovascular structure, high tumor differentiation could be seen in the tumor with hypo-attenuation peripheral. When microvessel density (MVD) >30 in the peripheral of the HCC lesions, the incidence rate of metastasis was high. Conclusion The integrity of tumor capsul could be well reflected by the CT patterns of the peripheral of HCC. The patterns were useful to estimate the extent of tumor invasion as well as grading of tumor cell. The peripheral enhancement features of HCC on multi-detector spiral CT dural-phase scanning could reflect the histopathologic characteristics and predict the prognosis to a certain degree. |
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