Sequential Hemodynamic Change in Hepatocellular Carcinoma and Dysplastic Nodule: CT Angiography and Pathologic Correlation

肝细胞癌和发育不良结节的连续血流动力学变化：CT 血管造影和病理相关性

• 批准号: 11670899
• 负责人: AIBE Hitoshi
• 金额: $ 2.18万
• 依托单位: KYUSHU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11670899/
• 关键词: Hepatocellular carcinoma; CTAP; CTA; Angiogenesis; Angiogenesis

The purpose of this study was to clarify the hemodynamic changes associated with hepatocarcinogenesis using CT angiography. Eighty-six hepatocellular lesions in 49 patients who underwent CT with both hepatic arteriography and arterioportography were pathologically confirmed. These images were compared with lesion-to-liver vascular ratios of cumulative arteries, preexisting hepatic arteries, and portal veins in resected specimens. Lesions were classified into five groups according to intranodular hemodynamics determined by CT hepatic arteriography and CT during arterioportography; group 1: isoattenuating on both; group 2: hypoattenuating on CT hepatic arteriography and isoattenuating on CT during arterioportography; group 3: hypoattenuating on both; group 4: isoattenuating on CT hepatic arteriography and hypoattenuating on CT during arterioportography; and group 5: hyperattenuating on CT hepatic arteriography and hypoattenuating on CT during arterioportography. .Among 86 lesions, there were 7 low-grade dysplastic nodules, 8 high-grade dysplastic nodules, 14 well-differentiated hepatocellular carcinomas, 45 moderately differentiated hepatocellular carcinomas, and 12 poorly differentiated hepatocellular carcinomas. The lesions were classified into group 1 (n=5), group 2 (n=13), group 3 (n=6), group 4 (n=2), and group 5 (n=60). Intranodular hemodynamics was significantly correlated with pathologic gradings (p<.001). For correlations between combinations of the groups and patnologic gradings, the order "groups 1-2-3-4-5" was the most significant (p<.001). During hepatocarcinogenesis, most hepatocellular nodules show deterioration of arterial blood flow before loss of portal blood flow. Vascular imaging of hepatic nodules may predict malignant pathology via the early loss of hepatic arterial flow prior to portal flow changes.

本研究的目的是利用CT血管造影术阐明与肝癌发生相关的血流动力学改变。49例CT同时行肝动脉造影和门脉造影的患者中，86例肝细胞病变均经病理证实。将这些图像与切除标本中累积动脉、预先存在的肝动脉和门静脉的病变与肝血管的比率进行比较。根据CT肝动脉造影和CT门脉造影确定的结节内血流动力学改变分为5组：第1组：两者均等密度；第2组：CT肝动脉低密度、CT等密度；第3组：两者均低密度；第4组：肝动脉CT等密度、CT低密度；第5组：肝动脉CT高密度、CT低密度。86个病灶中，低度异型结节7个，高度异型结节8个，高分化型14个，中分化型45个，低分化型12个。病变分为组1(n=5)、组2(n=13)、组3(n=6)、组4(n=2)和组5(n=60)。结节内血流动力学与病理分级显著相关(p&lt；.001)。对于组的组合与类型分级的相关性，“组1-2-3-4-5”的顺序是最显著的(p&lt；.001)。在肝细胞癌变过程中，大多数肝细胞结节在门静脉血流丧失之前表现为动脉血流恶化。肝脏结节的血管成像可以通过在门静脉血流改变之前肝动脉血流的早期丧失来预测恶性病理。

项目成果

Honda H,Tajima T,Tanguchi K,Kuroiwa T,Yoshimitsu K,Irie H,Aibe H, et al: "Recenet development in imaging diagnostics for HCC : CT arteriography and CT arterioportography evaluation of vascular changes in premalignant and malignant hepatic nodules"J Hepato

Honda H、Tajima T、Tanguchi K、Kuroiwa T、Yoshimitsu K、Irie H、Aibe H 等人：“HCC 影像诊断的最新进展：CT 动脉造影和 CT 动脉门静脉造影评估癌前和恶性肝结节的血管变化”J

Honda H, Tajima T, Taguchi K, Kuroiwa T, Yoshimitsu K, Irie H, Aibe H, Shinozaki K, Asayama Y, Shimada M, Masuda K: "Recent development in imaging diagnostics for HCC: CT arteriography and CT arterioportography evaluation of vascular changes in premaligna

Honda H、Tajima T、Taguchi K、Kuroiwa T、Yoshimitsu K、Irie H、Aibe H、Shinozaki K、Asayama Y、Shimada M、Masuda K：“HCC 影像诊断的最新进展：CT 动脉造影和 CT 动脉门静脉造影评估血管

Honda H, Tajima T, Kajiyama K, Kuroiwa T, Yoshimitsu K, Irie H, Aibe H, Shimada M, Masuda K: "Vascular changes in hepatocellular carcinoma : correlation of radiologic and pathologic findings"American Journal of Roentgenology. 173・5. 1213-1217 (1999)

Honda H、Tajima T、Kajiyama K、Kuroiwa T、Yoshimitsu K、Irie H、Aibe H、Shimada M、Masuda K：“肝细胞癌的血管变化：放射学和病理学结果的相关性”美国伦琴学杂志 173・5。 1213-1217 (1999)

H.Honda,H.Aibe,K.Yoshimitsu,T.Tajima,et al.: "Vascular changes in hepatocellular carcinoma : correlation of radiologic and pathologic findings"American Journal of Roentgenology. 173. 1213-1217 (1999)

H.Honda，H.Aibe，K.Yoshimitsu，T.Tajima，et al.：“肝细胞癌的血管变化：放射学和病理学结果的相关性”美国伦琴学杂志。

Tajima T, Honda H, Taguchi K, Asayama Y, Kuroiwa T, Yoshimitsu K, Irie H, Aibe H, Shimada M, Masuda K: "Sequential hemodynamic change in hepatocellular carcinoma and dysplastic nodule : CT angiography and pathologic correlation"American Journal of Roentge

Tajima T、Honda H、Taguchi K、Asayama Y、Kuroiwa T、Yoshimitsu K、Irie H、Aibe H、Shimada M、Masuda K：“肝细胞癌和发育不良结节的连续血流动力学变化：CT 血管造影和病理相关性”美国杂志