| 摘要: |
| 目的分析甲胎蛋白（AFP）阴性原发性肝细胞癌（HCC）的CT表现，为CT诊断AFP阴性HCC提供有价值的影像学依据。方法选取经病理学检查确诊为HCC的患者80例，根据患者入院后血清AFP检测结果，将AFP阴性表达（＜20滋g/ml）者设为阴性组（32例），阳性表达(≥20滋g/ml)者设为阳性组（48例）。两组患者均空腹行上腹部CT平扫及增强扫描。观察并比较两组患者的CT表现。结果阴性组患者多数病灶CT表现为体积偏小（长径＜3cm），单灶，边缘及形态相对较规则，呈椭圆形或边缘轻度分叶状改变，密度相对均匀，很少出现坏死、出血等征象，较少发生转移或门静脉癌栓。阳性组患者CT平扫表现多为病灶体积偏大（长径＞3cm），多伴子灶出现，边缘不规则，易发生坏死、出血，且易发生门静脉癌栓或转移。两组患者病灶长径＜3cm、单灶生长、边缘规则、坏死或出血、门静脉癌栓或转移比例比较差异均有统计学意义（均P＜0.05）。与阳性组比较，阴性组患者增强CT动脉期高度强化比例较低，轻度强化比例较高（P＜0.05）；静脉期高度强化比例较高，轻度强化比例较低（P＜0.05）。结论AFP阴性HCC的CT表现具有肿瘤体积相对偏小、多单发、形态相对规则、出血坏死少见、不易发生门静脉癌栓或转移、增强扫描以动脉血供相对偏少而静脉血供优势等特征。 |
| 关键词: 肝细胞癌 甲胎蛋白 X 线计算机成像 阴性 诊断 |
| DOI：10.12056/j.issn.1006-2785.2017.39.19.2017-440 |
| 分类号: |
| 基金项目:杭州市卫生科技计划项目（2016A20）；浙江省医学会临床科研基金项目（2016ZYC-A40） |
|
| CT imaging manifestation of AFP-negative hepatocellular carcinoma |
|
|
|
the Affiliated Hospital of Hangzhou Normal University
|
| Abstract: |
| Objective To analyze the CT imaging manifestation of AFP-negative hepatocellular carcinoma (HCC).
Methods Eighty patients with HCC confirmed by pathology admitted from October 2014 to October 2016 were enrolled in the study, including 32 cases with AFP＜20滋g/ml (AFP-negative group) and 48 cases with AFP≥20滋g/ml (AFP-positive group). The plain and contrast CT scan of upper abdomen were performed and the CT imaging findings were observed and compared between two groups. Results The CT findings of most lesions in AFP-negative group showed a solitary oval or mild lobulated mass of major axis ＜3cm, with relatively regular margin and usually homogeneous density, and hemorrhage or necrosis, metastasis and portal vein tumor thrombus were less likely to occur. On the contrary, lesions in AFP-positive group presented with irregular margin and large volume, mostly accompanying sub-lesions, and hemorrhage or necrosis, metastasis and portal vein tumor thrombus were likely to occur. There were significant differences in the major axis of lesion, solitary, regular margin, hemorrhage or necrosis and metastasis and portal vein tumor thrombus between two groups (P ＜0.05). Compared with AFP-positive group, the ratio of intense enhancement on arterial phase of contrast scan was low, and the mild enhancement rate was high (P＜0.05), while the ratio of intense enhancement on venous phase was high, and the mild enhancement rate was low (P ＜0.05). Conclusion Compared to AFP-positive HCC, the CT imaging manifestations in AFP-negative patients are characteristic on plain scan, and demonstrate less arterial blood supply and abundant blood supply on venous phase of contrast enhancement. |
| Key words: Hepatocellular carcinoma Alpha fetal protein X-ray computed tomography Negative Diagnosis |
