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目的:研究MR与CT影像能否诊断出肝细胞癌的包膜外浸润,若能诊断出,那么能否确认其在MR与CT影像上的特征性表现。材料与方法:为了弄清手术所见与MR及CT影像表现之间的关系,对患有小型肝细胞癌(直径≤3.0cm)的38例病人进行了研究。结果:38例病人中有10例在组织学上证实有肝细胞癌的包膜外浸润,在有包膜外浸润的这10例病人中,9例病人在T1加权像上和5例病人在增强后的CT像上观察到肿瘤的部分突向肿瘤周围带,或在肿瘤附近呈星芒状结节。在没有肝细胞癌包膜外浸润的病人中,未观察到肿瘤突起或星芒状结节。这些特殊征象的检出率,在MR上为90％而在CT上为50％。结论:MR与CT影像均有助于肝细胞癌包膜外浸润的诊断,肝细胞癌包膜外浸润的特有征象为肿瘤部分突向肿瘤周围带或在肿瘤附近呈星芒状结节。
Objective: To study whether MR and CT images can diagnose the extracapsular infiltration of hepatocellular carcinoma. If it can be diagnosed, can it confirm its characteristic features on MR and CT images. Materials and Methods: In order to understand the relationship between surgical findings and MR and CT imaging findings, 38 patients with small hepatocellular carcinoma (diameter ≤ 3.0 cm) were studied. RESULTS: Ten out of 38 patients had histologically confirmed extracapsular infiltration of hepatocellular carcinoma. Of the 10 patients with extracapsular infiltration, 9 were on T1-weighted images and 5 were On the enhanced CT image, a portion of the tumor was observed to protrude around the tumor, or a stellate-like nodule was observed near the tumor. In patients without extracapsular hepatocellular carcinoma, no tumor neurites or stellate-like nodules were observed. The detection rate of these special signs is 90% in MR and 50% in CT. Conclusion: Both MR and CT images are helpful for the diagnosis of extracapsular infiltration of hepatocellular carcinoma. The special sign of extracapsular infiltration of hepatocellular carcinoma is that the tumor partially protrudes to the periphery of the tumor or shows a stellate-like nodule near the tumor.