Hepatocellular-cholangiocarcinoma: Helical computed tomography findings in 30 patients
Hepatocellular-cholangiocarcinoma: Helical computed tomography findings in 30 patients
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DOI：
10.1097/00004728-200303000-00003
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发表时间：
2003-03-01
影响因子：
1.3
通讯作者：
Vilgrain, V
中科院分区：
文献类型：
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作者：
Ebied, O;Federle, MP;Vilgrain, V
目的：方法：对30例肝细胞胆管癌患者的年龄、性别、肿瘤危险因素、血清肿瘤标志物、临床症状、肿瘤形态及增强扫描进行分析。患者年龄范围为27 - 78岁（平均= 58岁）。30例患者中有21例出现腹部体征或症状，30例患者中有25例（83%）患有慢性肝病。螺旋CT显示所有患者的肿瘤边界清楚，并伴有恶性肿瘤体征，如肝血管丰富（63%）、胆道梗阻（17%）、卫星病变（40%）和淋巴结肿大（27%）。部分肿瘤在动脉期成像上呈高衰减，而在所有其他期成像上呈低衰减，而其他部分显示延迟性持续增强，有时（27%）伴有肝包膜回缩，这些发现分别被报道为肝细胞癌和胆管细胞癌的特征。当肝脏肿瘤同时具有肝细胞癌和胆管细胞癌的CT表现时，应考虑肝细胞胆管细胞癌的诊断。放射科医生应该了解这种肿瘤类型，以便正确进行活检，以便进行足够的组织采样。
Objective: To report the helical multiphasic computed tomography (CT) findings in 30 patients with hepatocellular-cholangiocarcinoma.Method: We evaluated age, gender, tumor risk factors, serum tumor markers, symptoms, and tumor morphology and enhancement on helical multiphasic CT in 30 patients.Results: Twenty-six of 30 patients (86%) were men. Patients had an age range of 27-78 years (mean = 58 years). Abdominal signs or symptoms were present in 21 of 30 patients, and 25 of 30 (83%) had chronic liver disease. Helical CT demonstrated a well-defined tumor in all patients with signs of malignancy such as hepatic hypervascularity (63%), biliary obstruction (17%), satellite lesions (40%), and lymphadenopathy (27%). Portions of the tumor were hyperattenuated on arterial-phase imaging and hypoattenuated on all other phases, whereas other portions showed delayed persistent enhancement, sometimes (27%) with hepatic capsular retraction, findings that have been reported to be characteristic of hepatocellular carcinoma and cholangiocarcinoma, respectively.Conclusion: The diagnosis of hepatocellular-cholangiocarcinoma should be considered when a hepatic tumor has CT features of both hepatocellular carcinoma and cholangiocarcinoma. Radiologists should be aware of this tumor type so that the biopsy is performed properly to allow sufficient tissue sampling.