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目的探讨原发性透明细胞型肝癌(PCCCL)的MRI表现,并与临床病理进行对照,以提高其诊断准确性。方法回顾性分析10例经手术病理证实的PCCCL患者的MRI表现及临床资料,并复习文献。结果 10例均为中老年男性,8例有乙肝病史,5例AFP阳性。病灶单发,肝右叶8例,左叶2例,呈椭圆形,结节状,边界较清。MR T1WI上病灶呈不均匀等、低信号,T2WI上为相对高信号,T2WI脂肪抑制和反相位上病灶信号衰减,DWI多呈混杂高信号。增强动脉期呈不均匀轻至中度强化,门静脉期及延迟期呈相对低信号,病灶内有无强化的低信号区,4例病灶见环形强化的假包膜。结论 PCCCL具有一定特征的MRI表现,综合多种检查方法并结合临床,将有助于该病的明确诊断,确诊依赖病理。
Objective To investigate the MRI findings of primary clear cell hepatocellular carcinoma (PCCCL) and to compare it with clinical pathology to improve its diagnostic accuracy. Methods The MRI findings and clinical data of 10 patients with PCCCL confirmed by surgery and pathology were retrospectively reviewed. The literature was reviewed. Results All 10 cases were middle-aged and old men, 8 had history of hepatitis B, and 5 had AFP positive. Single lesions, the right lobe in 8 cases, left lobe in 2 cases, oval, nodular, border more clear. MR T1WI lesions were uneven, low signal, T2WI is relatively high signal, T2WI fat suppression and anti-phase lesion signal attenuation, DWI mostly mixed high signal. The enhancement of arterial phase was uneven mild to moderate enhancement, portal vein and delayed phase was relatively low signal, with or without enhancement of the lesion in the low signal area, 4 cases of lesions seen ring enhanced pseudocapsule. Conclusions PCCCL has certain characteristics of MRI manifestations, combined with a variety of examination methods combined with clinical, will help to confirm the diagnosis of the disease, diagnosis-dependent pathology.