摘要
目的探讨肝细胞性肝癌(HCC)的影像学征象与手术预后的关系,深入认识影像征象的意义,为临床设计更加合理的治疗方案提供客观依据。方法搜集65例经手术病理证实的HCC患者资料。65例HCC患者术前都进行CT或MRI平扫及增强扫描,其影像学征象包括肿瘤包膜、大小、肿瘤血管、门静脉癌栓、肿瘤坏死、合并肝硬化、肿瘤数目(单发或多发)等情况,将上述影像征象与预后进行统计分析。结果 65例HCC手术患者,手术前行影像学扫描,发现其中有包膜43例,无包膜22例;≤3 cm 19例,>3 cm 46例;MSCT或MRI多期增强扫描,HCC在动脉期显示肿瘤血管41例,未见肿瘤血管显示24例;门静脉癌栓15例,未见癌栓50例;肿瘤坏死51例,14例未见坏死灶;合并肝硬化16例,未见肝硬化49例;肝内出现多发结节53例,单发结节12例。65例术后随访2年,肿瘤转移或复发26例,未见转移或复发39例。HCC影像所表现的肿瘤包膜、大小、门静脉癌栓、合并肝硬化与预后的相关性差异有显著统计学意义(P<0.05);其他征象如肿瘤血管、肿瘤坏死和肿瘤数目与预后的相关性差异无显著统计学意义(P>0.05)。结论 HCC影像表现在一定程度上可反映患者的手术预后情况,为术前指导临床制定个体化治疗或手术方案提供依据。
Objective To explore the correlation of the HCC （Hepatocellular carcinoma, HCC） imaging features with its prognosis, to understand the meaning of the imaging features, and provide objective basis for a more reasonable clinical treatment of the tumor. Methods 65 cases of HCC tissue specimens confirmed by surgery and pathology were collected. Postoperative follow - up of the 65 patients was done over 2 years. 26 cases were of tumor recurrence and 39 cases were of non - recurrent tumor. All the 65 cases of HCC had preoperative CT or MRI scan and enhanced scan. A statistical analysis was carried out by evaluating the imaging signs which consisted of the tumor capsule, tumor size, tumor vascularity, portal venous tumor thrombus, tumor necrosis, liver cirrhosis, number of lesions （single or multiple） , and the prognosis in relation to the imaging signs was analyzed. Results Of the 65 patients of HCC who underwent medical imaging scans, 43 cases were found to have tumor capsules, 22 cases had no capsules. 19 cases had lesions of size equal to or less than 3 cm, 46 cases had sizes exceeding 3 cm. On MSCT or MRI muhiphase enhancement scan, 41 cases showed tumor vascularity in the arterial phase , 24 cases did not display tumor vascularity. Portal venous tumor thrombus was identified in 15 cases and it was not seen in 50 cases; Tumor necrosis was seen in 51 cases and the remainder 14 cases had no necrosis. 16 cases had accompanying liver cirrhosis, 49 cases did not have identifiable liver cirrhosis. Multiple Intrahepatie nodules were diag- nosed in 53 cases and 12 cases had single nodules. HCC images had prognosis with a significant difference（ P 〈 0.05 ） with respect to tumor capsule, size, portal venous tumor thrombus and liver cirrhosis. Other signs, such as tumor vascularity, tumor necrosis, number of lesions and prognosis had no significant difference （P 〉 0.05 ） in prognosis. Conclusion To a certain degree, HCC imaging characteristics can reflect the surgical prognosis of the patients and the scheme for preoperative clinical individualized treatment or surgery.
作者
陆玉敏
吴英宁
李恒国
LU Yumin WU Yingning LI Hengguo(Department of Medical Imaging, the Affiliated Hospital of Youjiang National Medical College, Baise, Guangxi Province 533000, P. R. Chin)
出处
《临床放射学杂志》
CSCD
北大核心
2016年第11期1718-1721,共4页
Journal of Clinical Radiology
作者简介
通讯作者
