摘要
目的直径<2cm的肝脏占位通常不具备典型的肝脏肿瘤影像学特点,当甲胎蛋白化验结果阴性时诊断尤其困难,通过对这部分病例诊治过程和随诊结果的回顾和分析,总结甲胎蛋白阴性的小肝占位病例的诊治经验。方法我科2003年1月～2008年12月共收治103例直径≤2cm且甲胎蛋白阴性的肝脏占位病例,根据肿瘤多发性选择数字减影血管成像(DSA)、动态增强磁共振成像(MRI)、造影超声或PET-CT进行鉴别诊断,对于疑诊的94例病例行部分肝切除术。结果这四种检查手段对肝脏恶性肿瘤的诊断准确率分别为88.2%、93.9%、88.9%和88.9%;本组手术病例手术并发症率低(6.4%)、预后良好,肝癌病例的1年生存率和3年生存率分别为98.8%和76.1%。结论 DSA、动态增强MRI、造影超声和PET-CT检查对于小肝占位均有很好的诊断价值;手术方式宜采取肝脏部分切除术;小肝癌病例手术风险小、预后好,对于疑诊病例应积极进行手术治疗。
Objective To summarize our experiences in diagnosis and management of small hepatic lesions with negative alpha- fetoprotein （AFP）. Methods Totally 103 patients with hepatic small lesions （2cm and of negative serum AFP were enrolled from our department during the past six years. For differential diagnosis, digital subtraction angiography （ DSA）, dynamic contrast - enhanced magnetic resonance imaging （ MRI）, contrasted ultrasonography, or positive emission tomography - computed tomography （ PET - CT） was selected, according to whether tumors occurred singly or were multiple. Liver resection was performed in 94 patients suspected of cancer. Results The diagnostic accuracy of the four procedures in defining the malignancies of hepatic masses was 88.2% , 93.9% , 88. 9% , and 88.9% , respectively. The patients who＇ had undergone surgeries experienced a low incidence of complications （6.4%） , and good prognosis, ＇with 1 - and 3 - year survival of 98. 8% and 76. 1%, respectively. Conclusions DSA, dynamic contrast - enhanced MRI, contrasted ultrasonography, and PET - CT are all valuable in the diagnosis of small hepatic lesions. Partial liver resection, with low risk and favorable prognosis, is recommended.
出处
《癌症进展》
2010年第3期285-289,共5页
Oncology Progress
基金
美国China Medical Board of New York基金资助(项目编号:CMB 06-837)
关键词
肝脏占位
造影超声
动态增强核磁
PET—CT
肝切除术
hepatic lesion （s） contrasted ultrasonography dynamic contrast - enhanced magnetic resonance imagingPET - CT hepatectomy
