超声造影诊断完全及部分肉瘤样肝肉瘤样癌的特征观察

摘要/Abstract

摘要： 目的研究超声造影诊断完全及部分肉瘤样肝肉瘤样癌的特征。方法纳入2017年4月至2018年4月于我院收治的86例肝肉瘤样癌患者为研究对象,开展回顾性分析。参照病理结果,根据病灶有无完全肉瘤样变,将入选的患者分为A组(病灶完全肉瘤样变,52例)和B组(病灶部分肉瘤样变,34例)。比较两组常规超声及超声造影表现,观察肝肉瘤样癌病灶大小与超声造影动脉期增强表现的相关性。结果常规超声结果显示,两组病灶最大径、病灶回声比较差异无统计学意义(P＞0.05)。超声造影结果显示,A组所有病灶动脉期均呈环状高增强,B组所有病灶均呈整体高增强,差异有统计学意义(P<0.05)。两组超声造影门脉期病灶主要以低回声为主,超声造影延迟期所有病灶均呈低回声表现,差异无统计学意义(P＞0.05)。86个病灶中有46个病灶属小病灶(最大径＜50 mm),40个病灶属大病灶(最大径≥50 mm),所有小病灶超声造影动脉期增强表现较大病灶比较差异无统计学意义(P＞0.05)。结论肝肉瘤样癌超声造影表现与肿瘤内肉瘤样变程度密切相关,尤其是在超声造影动脉期,部分肉瘤样变者均呈整体高增强,完全肉瘤样变者均呈环状高增强。

关键词: 超声造影, 部分肉瘤样变, 完全肉瘤样变, 肝肉瘤样癌

王辉军, 刘灿. 超声造影诊断完全及部分肉瘤样肝肉瘤样癌的特征观察[J]. 肝脏, 2020, 25(5): 538-540.

参考文献

[1] 赵越, 龙世亮, 田执南, 等. 低度恶性纤维黏液样肉瘤的MRI表现. 中华放射学杂志, 2015, 49:313-314.
[2] Alguacilgarcia A, Weiland LH. The histologic spectrum, prognosis, and histogenesis of the sarcomatoid carcinoma of the pancreas. Cancer, 2015, 39:1181-1189.
[3] Kan A, Guo RP. The prognosis of subsequent surgical treatment in patients with sarcomatoid carcinoma in the liver: a retrospective study. Int J Surg, 2018, 55:145-151.
[4] Koo HR, PARK, MiSuk, et al. Radiological and clinical features of sarcomatoid hepatocellular carcinoma in 11 cases. J Comput Assist Tomo, 2008, 32:745-749.
[5] 陈敏华, 严昆, 戴莹,等. 肝超声造影应用指南(2012年修改版). 中华超声影像学杂志, 2013, 22:696-722.
[6] Chang WW, Agha FP, Morgan WS. Primary sarcoma of the liver in the adult. Cancer, 2015, 51:1510-1517.
[7] 曹文斌, 陈琴, 罗俊. 肝肉瘤样癌超声造影表现一例. 中华消化病与影像杂志(电子版), 2018, 8:187-188.
[8] Leng Q, Xiang XI, Tang Y, et al. Primary hepatic sarcomatoid carcinoma: a case report. Exp Ther Med, 2015, 10:1145-1148.
[9] Seo N, Kim MJ, Rhee H. Hepatic sarcomatoid carcinoma: magnetic resonance imaging evaluation by using the liver imaging reporting and data system. Eur Radiol, 2019, 29:3761-3771.
[10] 李旭, 郭晓林, 季慧范, 等. 肝肉瘤样癌一例. 中华传染病杂志, 2017, 35:116-117.
[11] Gurria JP, Acosta D M D, Hafezi N, et al. Spindle cell sarcomatoid carcinoma of the trachea: first case report of surgical resection. J Cardiothorac Surg, 2016, 11:128-132.
[12] Tsujimoto M, Aozasa K, Nakajima Y, et al. Hepatocellular carcinoma with sarcomatous proliferation showing an unusual and wide-spread metastasis. Acta Pathol Jpn, 2015, 34:839-845.
[13] Lee JW, Kim MW, Choi NK, et al. Double primary hepatic cancer (sarcomatoid carcinoma and hepatocellular carcinoma): A case report. Mol Clin Oncol, 2014, 2:949-952.
[14] 龚金龙, 彭创, 刘宇,等. 肉瘤样肝细胞癌一例. 中华普通外科杂志, 2018, 33:352-353.
[15] Lu J, Zhang J, Xiong XZ, et al. Primary hepatic sarcomatoid carcinoma: clinical features and prognosis of 28 resected cases. J Cancer Res Clin Oncol, 2014, 140:1027-1035.