Hepatocarcinogenesis: Multistep Changes of Drainage Vessels at CT during Arterial Portography and Hepatic Arteriography-Radiologic-Pathologic Correlation
Hepatocarcinogenesis: Multistep Changes of Drainage Vessels at CT during Arterial Portography and Hepatic Arteriography-Radiologic-Pathologic Correlation
复制标题
DOI：
10.1148/radiol.2522081414
复制
发表时间：
2009-08-01
期刊：
影响因子：
19.7
通讯作者：
Nakanuma, Yasuni
中科院分区：
文献类型：
--
作者：
Kitao, Azusa;Zen, Yoh;Nakanuma, Yasuni
目的：目的：以肝组织学检查结果为参考标准，通过CT动脉门静脉造影（CTAP）和CT肝动脉造影（CTHA），明确异型增生结节和肝细胞癌（HCC）在肝癌发生过程中引流血管的变化。根据CTAP和CTHA的结果，46个手术切除的肝细胞结节分为三种类型：A型（n = 18）（CTAP时与背景肝脏相比，门静脉灌注相等或降低，CTHA时动脉灌注降低，无冠状增强[结节周围造影剂引流]），B型（n = 13）（无门脉灌注，动脉灌注增加，冠状强化较薄（2 mm））。结果：A型结节由异型增生结节和高分化HCC组成，B型和C型结节为中分化HCC。A型结节中常见替代生长，而B型和C型结节中更常见压缩生长。60%的C型结节有纤维包膜。B型和C型结节内肝静脉明显较少。病理切片显示A型结节内毛细血窦与肝静脉连续，B型结节内毛细血窦与周围肝血窦连续。在C型结节中，结节内毛细血管化的血窦直接或通过纤维囊内的门静脉与结节内的门静脉相连。结论：在肝癌的多阶段演变过程中，引流血管由肝静脉向肝窦再向门静脉转变。(c)RSNA，2009年
Purpose: To clarify the changes that occur in drainage vessels of dysplastic nodules and hepatocellular carcinoma (HCC) during hepatocarcinogenesis by using computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA), with histologic findings as the reference standard.Materials and Methods: Institutional ethics committee approval and informed consent were obtained. According to the findings at CTAP and CTHA, 46 surgically resected hepatocellular nodules were classified into three types: type A (n = 18) (equivalent or decreased portal perfusion compared with background liver at CTAP, decreased arterial perfusion, and no corona enhancement [perinodular contrast material drainage] at CTHA), type B (n = 13) (no portal perfusion, increased arterial perfusion, and thin ( 2-mm) corona enhancement). We compared the histopathologic features and microangioarchitecture between the types.Results: Type A nodules histologically consisted of dysplastic nodules and well-differentiated HCC; type B and C nodules were moderately differentiated HCC. Replacing growth was commonly observed in type A nodules, whereas compressing growth was more frequently seen in types B and C. Sixty percent of type C nodules had a fibrous capsule. There were significantly fewer intranodular hepatic veins in types B and C. Serial pathologic slices demonstrated continuity from intranodular capillarized sinusoids to hepatic veins in type A nodules and to surrounding hepatic sinusoids in type B nodules. In type C nodules, intranodular capillarized sinusoids were connected to extranodular portal veins either directly or through portal venules within the fibrous capsule.Conclusion: Drainage vessels of HCC change from hepatic veins to hepatic sinusoids and then to portal veins during multistep hepatocarcinogenesis. (c) RSNA, 2009