肝癌的影像学诊断进展

张春雨; 付宇; 李晓东; 李永瑞; 张惠茅

doi:10.3969/j.issn.1001-5256.2017.07.012

肝癌的影像学诊断进展

DOI: 10.3969/j.issn.1001-5256.2017.07.012

吉林大学第一医院放射线科

详细信息

中图分类号: R445;R730.44;R735.7
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出版历程
- 收稿日期: 2017-05-13
- 出版日期: 2017-07-20

Advances in imaging diagnosis of liver cancer

Department of Radiology, The First Hospital of Jilin University

摘要

摘要: 原发性肝癌诊断的金标准为肝活组织检查,但作为有创检查其临床应用具有一定的局限性。目前影像学已经成为诊断肝癌的首选方法。总结了近年影像学诊断及评估原发性肝癌的新方法和新技术,如超声造影、CT灌注成像﹑弥散加权成像相关技术-体素不相干运动（DWI-IVIM）、IDEAL IQ序列、动态增强MRI及肝细胞特异性造影剂成像等,认为影像诊断不仅可以评估病灶的分化程度、血供与灌注情况、病灶的侵袭性,而且还可以预测预后,对背景肝功能进行评估,从而为临床诊治提供更多参考。
- 肝肿瘤 /
- 诊断显像
Abstract: Liver biopsy is the gold standard for the diagnosis of primary liver cancer, but it is an invasive examination.At present, imaging has become the preferred method for the diagnosis of liver cancer.This article summarizes new imaging methods and techniques for the diagnosis and evaluation of primary liver cancer, including contrast-enhanced ultrasound, CT perfusion imaging, diffusion-weighted imaging-intravoxel incoherent motion, IDEAL IQ sequence, dynamic contrast-enhanced MRI, and hepatocyte-specific contrast-enhanced imaging, and points out that diagnostic imaging can not only evaluate the degree of tumor differentiation, blood supply and perfusion, and invasiveness of lesions, but also predict the prognosis and evaluate liver function.Therefore, it can provide a reference for clinical diagnosis and treatment.
- liver neoplasms /
- diagnostic imaging

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参考文献(26)

[1]EL-SERAG HB, RUDOLPH KL.Hepatocellular carcinoma:epidemiology and molecular carcinogenesis[J].Gastroenterology, 2007, 132 (7) :2557-2576.

[2]BOTA S, PISCAGLIA F, MARINELLI S, et al.Comparison of international guidelines for noninvasive diagnosis of hepatocellular carcinoma[J].Liver Cancer, 2012, 1 (3-4) :190-200.

[3]European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer.EASL-EORTC clinical practice guidelines:management of hepatocellular carcinoma[J].J Hepatol, 2012, 56 (4) :908-943.

[4]LEE JH, LEE JM, KIM SJ, et al.Enhancement patterns of hepatocellular carcinomas on multiphasicmultidetector row CT:comparison with pathological differentiation[J].Br J Radiol, 2012, 85 (1017) :e573-e583.

[5]NAKANISHI M, CHUMA M, HIGE S, et al.Relationship between diffusion-weighted magnetic resonance imaging and histological tumor grading of hepatocellular carcinoma[J].Ann Surg Oncol, 2012, 19 (4) :1302-1309.

[6]HEO SH, JEONG YY, SHIN SS, et al.Apparent diffusion coefficient value of diffusion-weighted imaging for hepatocellular carcinoma:correlation with the histologic differentiation and the expression of vascular endothelial growth factor[J].Korean J Radiol, 2010, 11 (3) :295-303.

[7]NASU K, KUROKI Y, TSUKAMOTO T, et al.Diffusion-weighted imaging of surgically resected hepatocellular carcinoma:imaging characteristics and relationship among signal intensity, apparent diffusion coefficient, and histopathologic grade[J].AJR Am J Roentgenol, 2009, 193 (2) :438-444.

[8]XU P, ZENG M, LIU K, et al.Microvascular invasion in small hepatocellular carcinoma:is it predictable with preoperative diffusion-weighted imaging?[J].J Gastroenterol Hepatol, 2014, 29 (2) :330-336.

[9]WOO S, LEE JM, YOON JH, et al.Intravoxel incoherent motion diffusion-weighted MR imaging of hepatocellular carcinoma:correlation with enhancement degree and histologic grade[J].Radiology, 2014, 270 (3) :758-767.

[10]SCHUHMANN-GIAMPIERI G, SCHMITT-WILLICH H, PRESSWR, et al.Preclinical evaluation of Gd-EOB-DTPA as a contrast agent in MR imaging of the hepatobiliary system[J].Radiology, 1992, 183 (1) :59-64.

[11]van MONTFOORT JE, STIEGER B, MEIJER DK, et al.Hepatic uptake of the magnetic resonance imaging contrast agent gadoxetate by the organic anion transporting polypeptide Oatp1[J].J Pharmacol Exp T-her, 1999, 290 (1) :153-157.

[12]LEE YJ, LEE JM, LEE JS, et al.Hepatocellular carcinoma:diagnostic performance of multidetector CT and MR imaging-asystematic review and meta-analysis[J].Radiology, 2015, 275 (1) :97-109.

[13]KIERANS AS, KANG SK, ROSENKRANTZ AB.The diagnostic performance of dynamic contrast-enhanced MR imaging for detection of small hepatocellular carcinoma measuring up to 2cm:a meta-analysis[J].Radiology, 2016, 278 (1) :82-94.

[14]ZENG MS, YE HY, GUO L, et al.Gd-EOB-DTPA-enhanced magnetic resonance imaging for focal liver lesions in Chinese patients:a multicenter, open-label, phase III study[J].Hepatobiliary Pancreat Dis Int, 2013, 12 (6) :607-616.

[15]KUDO M, MATSUI O, SAKAMOTO M, et al.Role of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in the management of hepatocellular carcinoma:consensus at the Symposium of the 48th Annual Meeting of the Liver Cancer Study Group of Japan[J].Oncology, 2013, 84 (Suppl 1) :21-27.

[16]Ministry of Health of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2011) [J].J Clin Hepatol, 2011, 27 (11) :1141-1158. (in Chinese) 中华人民共和国卫生部.原发性肝癌诊疗规范 (2011年版) [J].临床肝胆病杂志, 2011, 27 (11) :1141-1158.

[17]YOO SH, CHOI JY, JANG JW, et al.Gd-EOB-DTPA-enhanced MRI is better than MDCT in decision making of curative treatment for hepatocellular carcinoma[J].Ann Surg Oncol, 2013, 20 (9) :2893-2900.

[18]WANG JH, CHEN TY, OU HY, et al.Clinical impact of gadoxetic acid-enhanced magnetic resonance imaging on hepatoma management:a prospective study[J].Dig Dis Sci, 2016, 61 (4) :1197-1205.

[19]LEE DH, LEE JM, BAEK JH, et al.Diagnostic performance of gadoxetic acid-enhanced liver MR imaging in the detection of HCCs and allocation of transplant recipients on the basis of the Milan criteria and UNOS guidelines:correlation with histopathologic findings[J].Radiology, 2015, 274 (1) :149-160.

[20]XIE S, LIU C, YU Z, et al.One-stop-shop preoperative evaluation for living liver donors with gadoxetic acid disodium-enhanced magnetic resonance imaging:efficiency and additional benefit[J].Clin Transplant, 2015, 29 (12) :1164-1172.

[21]AHN SS, KIM MJ, LIM JS, et al.Added value of gadoxetic acidenhanced hepatobiliary phase MR imaging in the diagnosis of hepatocellular carcinoma[J].Radiology, 2010, 255 (2) :459-466.

[22]KITAO A, MATSUI O, YONEDA N, et al.The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis:correlation with gadoxetic acid enhanced MR imaging[J].Eur Radiol, 2011, 21 (10) :2056-2066.

[23]ARIIZUMI S, KITAGAWA K, KOTERA Y, et al.A non-smooth tumor margin in the hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA) -enhanced magnetic resonance imaging predicts microscopic portal vein invasion, intrahepatic metastasis, and early recurrence after hepatectomy in patients with hepatocellular carcinoma[J].J Hepatobiliary Pancreat Sci, 2011, 18 (4) :575-585.

[24]CHOI JY, LEE JM, SIRLIN C.CT and MR imaging diagnosis and staging of hepatocellular carcinoma:part I.Development, growth, and spread:key pathologic and imaging aspects[J].Radiology, 2014, 272 (3) :635-654.

[25]WEST CM, Mc KAY MJ, HLSCHER T, et al.Molecular markers predicting radiotherapy response:report and recommendations from an International Atomic Energy Agency technical meeting[J].Int J Radiat Oncol Biol Phys, 2005, 62 (5) :1264-1273.

[26]YAMASHITA T, KITAO A, MATSUI O, et al.Gd-EOB-DTPA-enhanced magnetic resonance imaging and alpha-fetoprotein predict prognosis of early-stage hepatocellular carcinoma[J].Hepatology, 2014, 60 (5) :1674-1685.

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