摘要
目的分析无蒂型外生性肝癌的螺旋CT表现,提高对该病的诊断能力,并探讨螺旋CT及其多平面重建技术对该病的诊断价值。方法回顾性分析9例经病理证实的无蒂型外生性肝癌的螺旋CT表现;评价内容包括肿瘤的部位、大小、形态、边缘、密度、增强方式及程度、伴随征象等。结果9例无蒂型外生性肝癌均与肝脏边缘相连,呈向肝外生长的大肿块,病灶与肝连接处分界不清,并可见"鸟嘴征";其CT表现与肝内原发性肝癌相似,8例病灶内见"更低密度"坏死区,5例强化为典型的"快进快出"表现,4例病灶周边见迂曲血管影;CT多平面重建能更好地显示肿块与肝脏的关系。结论无蒂型外生性肝癌CT表现有一定特点,螺旋CT多期扫描及多平面重建技术对其诊断有重要临床价值。
Objective To analyze the helical CT features of exophytic hepatocellular carcinoma （E-HCC） without a pedicle, to improve the recognition and diagnosis ability of the disease, and to investigate the diagnostic value of helical CT and multiplanar reconstruction technique in the disease. Methods Nine cases of E-HCC without a pedicle proven by pathologically were included. The helical CT findings with regard to the location, size, contour, margin, density, contrast enhancement pattern and enhance degree, concomitance signs were retrospectively reviewed by two experienced radiologists. Results The E-HCC without a pedicle was connected with liver edge,presented a large mass exophytic to liver. Its contact surface with the regional liver edge was not well-defined and showed the ＂beak sign＂. The CT appearance of it was similar to that of primary hepatic carcinoma（HCC）. Eight cases showed ＂furthermore low density＂ zone of necrosis. Five cases were revealed the typical enhancement change characteristic of ＂rising and lowering rapidly＂ by density. Enhanced circuitous vessels were demonstrated during hepatic arterial phase in tumor edge of 4 cases. CT multiplanar reconstruction could demonstrate the relationship between tumor and liver preferably. Conclusion The E-HCC without a pedicle had some CT features. Hepatic multi-phase helical CT scanning and multiplanar reconstruction technique were of great value in diagnosing E-HCC without a pedicle.
