肝硬化结节多步癌变的病理及影像学表现

任崧; 叶兆祥; 朱理珉

肝硬化结节多步癌变的病理及影像学表现

天津市肿瘤防治重点实验室天津医科大学附属肿瘤医院放射科

详细信息

中图分类号: R735.7
计量
- 文章访问数: 6014
- HTML全文浏览量: 19
- PDF下载量: 1717
- 被引次数: 0
出版历程
- 出版日期: 2011-04-20

Pathological and imaging features of multistep process of cirrhosis nodules

摘要

摘要: 肝细胞癌(HCC)发生之前存在从再生结节(RN)、低级不典型增生结节(LGDN)、高级不典型增生结节(HGDN)、以及HCC病变逐渐演化过程,这些结节有不同的组织学特征。不典型增生可认为是HCC的癌前病变。影像学检查是区分这些结节的较敏感的方法。随着功能性成像技术(例如CTP、DWI、PWI、MRS等)的进展以及大量MR对比剂的应用,将有望在肝硬化结节的诊断中发挥重要作用并明显地有助于癌前病变的识别。
- 肝硬化 /
- 癌,肝细胞 /
- 结节病
Abstract: Before the emergence of hepatocellular carcinoma (HCC) , there is a sequence of events in hepatic nodules that from regenerative nodule (RN) , low-grade dysplastic nodule (LGDN) , high-grade dysplastic nodule (HGDN) , and HCC.They have different histopathilogic features.DN is recognized as precursors of HCC.CT and MRI are the sensitive imaging modalities for differentiating these lesions.Recent progress in function imaging modality, (such as CTP, DWI, PWI and MRS) and a variety of contrast agents using in MR imaging, will play a very important role in the imaging of multistep hepatocarcinogenesis and can be diagnostically helpful to identify a precancerous lesion.
- liver cirrhosis /
- carcinoma /
- hepatocellalar

HTML全文

参考文献(29)

[1]Gomma AI, Khan SA, Toledano MB, et al.Hepatocellularcarcinoma:epidemiology, risk factors and pathogenesis[J].World J Gastroenterol, 2008, 14 (27) :4300-4308.

[2]But DY, Lai CL, Yuen MF.Natural history of hepatitis-relatedhepatocellular carcinoma[J].World J Gastroenterol, 2008, 14 (11) :1652-1656.

[3]Kobayashi M, Ikeda K, Hosaka T, et al.Dysplastic nodulesfrequently develop into hepatocellular carcinoma in patientswith chronic viral hepatitis and cirrhosis[J].Cancer, 2006, 106 (3) :636-647.

[4]Ikada K, Saitch S, Suzuki y, et al.Relationship ofangiographic finding with neovascular structure detectedby immunohistochemical staining of alpha-smooth muscleactin in small hepatocellular carcinoma[J].J GastroenterolHepatol, 1998, 13 (12) :1266-1273.

[5]Thiese ND, Park YN, Thung SN."Vascular profiles"ofregenerative and dysplastic nodules[J].Hematology, 2000, 31 (6) :1380-1381.

[6]Hanna RF, Aguirre DA, Kased N, et al.Cirrhosis-associatedhepatocellular nodules:correlation of histopathologic and MRimaging features[J].Radiographics, 2008, 28 (3) :747-769.

[7]International Working Party.Terminology of nodularhepatocellular lesion[J].Hepatology, 1995, 22 (3) :983-993.

[8]Ito K, Mitchell DG, Gabata T, et al.Hepatocellular carcinoma:association with increased iron deposition in the cirrhoticliver at MR imaging[J].Radiology, 1999, 212 (1) :235-240.

[9]Roncalli M, Roz E, Coggi G, et al.The vascular profile ofregenerative and dysplastic nodules of the cirrhotic liver:Implications for diagnosis and classification[J].Hepatology, 1999, 30 (5) :1174-1178.

[10]International Consensus Group for Hepatocellular neoplasia.Pathologic diagnosis of early hepatocellular carcinoma:areport of the international consensus group for hepatocellularneoplasia[J].Hepatology, 2009, 49 (2) :658-664.

[11]Hytiroglou P.Morphological changes of early humanhepatocarcinogenesis[J].Semin liver Dis, 2004, 24 (1) :65-75.

[12]Kojiro M.Pathology of Hepatocellular Carcinoma[M].Oxford:Blackwell publishing, 2006.

[13]Hytiroglou P, Park YN, Krinsky G, et al.Hepatic precancerous lesions and small hepatocellular carcinoma[J].Gasteroenterol Clin N Am, 2007, 36 (4) :867-887.

[14]Park YN, Kojiro M, Di Tommaso L, et al.Ductular reaction ishelpful in defining early stomal invasion, small hepatocellularcarcinomas, and dysplastic nodules[J].Cancer, 2007, 109 (5) :915-923.

[15]Matsui O, Kadoya M, Kameyama T.et al.Benign andmalignant nodules in cirrhotic livers:distinction based onblood supply[J].Radiology, 1991, 178 (2) :493-497.

[16]Dodd GD 3rd, Baron RL, Oliver JH 3rd, et al.Spectrum ofimaging findings of the liver in end-stage cirrhosis:PartII.Focal abnormalities[J].AJR Am J Roentgenol, 1999, 173 (5) :1185-1192.

[17]Lim JH, Kim EY, Lee WJ, et al.Regenerative nodules in livercirrhosis:findings at CT during arterial portography and atCT hepatic arteriography with histopathologic correlation[J].Radiology, 1999, 210 (2) :451-458.

[18]Qayyum A, Graser A, Westphalan A, et al.CT of benignhypervascular liver nodules in autoimmune hepatitis[J].AJRAm J Roentgenol, 2004, 183 (6) :1573-1576.

[19]Efremidis SC, Hytiroglou P.The multistep process ofhepatocarcinogenesis in cirrhosis with imaging correlation[J].Eur Radiol, 2002, 12 (4) :753-764.

[20]Hussain SM, Zondervan PE, Ijzermans JNM, et al.Benign versusmalignant hepatic nodules:MR imaging findings with pathologiccorrelation[J].Radiographics, 2002, 22 (5) :1023-1039.

[21]Lim JH, Kim CK, Lee WJ, et al.Detection of hepatocellularcarcinomas and dysplastic nodules in cirrhotic livers:accuracy of helical CT in transplant patients[J].AJR, 2000, 175 (3) :693-698.

[22]Krinsky GA, Lee VS, Nguyen MT, et al.Siderotic nodules atMR imaging:regenerative or dysplastic?[J].J Comput AssistTomogr, 2000, 24 (5) :773-776.

[23]Fournier LS, Cuenod CA, de Bazelaire C, et al.Earlymodifications of hepatic perfusion measured by functionalCT in a rat model of hepatocellular carcinoma using a bloodpool contrast agent[J].Eur Radiol, 2004, 14 (11) :2125-2133.

[24]张亮, 周奇范卫君, 等.CT灌注成像对肝硬化结节及癌结节鉴别诊断价值的研究[J].中山大学学报, 2009, 30 (Suppl 4) :155-158.

[25]Xu H, Xie JX, Li X, et al.Perfusion-weighted MRI in evaluatingthe intranodular hemodynamic characteristics of dysplasticnodules and hepatocellular carcinomas in an experimental ratmodel[J].J Magn Reson Imaging, 2008, 27 (1) :102-109.

[26]Gourtsoyianni S, Papanikolaou N, Yarmenitis S, et al.Respiratory gated diffusion-weighted imaging of the liver:value of apparent diffusion coefficient measurements inthe differentiation between most commonly encounteredbenign and malignant focal liver lesions[J].Eur Radiol, 2008, 18 (3) :486-492.

[27]Demir OI, Obuz F, Sagol O, et al.Contribution of diffusion-weighted MRI to the differential diagnosis of hepaticmasses[J].Diagn Interv Radiol, 2007, 13 (2) :81-86.

[28]黄泽光, 谢长浓, 吴永峻.MR弥散加权成像诊断肝硬化不典型癌变结节[J].中国医学影像技术, 2010, 26 (4) :704-704.

[29]Foley LM, Towner RA, Painter DM.In vivo image-guided 1H-magnetic resonance spectroscopy of the serial developmentof hepatocarcinogenesis in an experimental animal model[J].Biochim Biophys Acta, 2001, 1526 (3) :230-236.

施引文献

资源附件(0)

访问统计