肝細胞癌のCT,MRI診断

概要

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The current frontiers of diagnostic imagings on hepatocellular carcinoma (HCC) are as follows: first, the detection of well differentiated HCC (w-HCC), and second, the detection and confirmation of moderately or poorly differentiated HCC (mp-HCC) less than 10 mm in diameter. HCC nodules developed first as w-HCC, and then they become mp-HCC (de-differentiation). The w-HCC shows more favorite prognosis than and -HCC. The detection rates of w-HCC histologically proved with hepatic resection and percutaneous ultrasonography-guided biopsy are 63 % (17/29) with X-ray computed tomography (CT), and 68 % (18/29) with magnetic resonance imaging (MRI). However, we may miss a lot of w -HCCs, because most of the HCC nodules are found as mp -HCC. Most of the mp -HCCs larger than 1cm in diameter are detected and confirmed with CT and MRI. The smaller mp -HCC nodules are difficult to detect and confirm, and CT with intra -arterial administration of contrast materials may show more nodules. Intrahepatic arterio - portal shunts and some of hyperplastic hepatocellular nodules (mainly developed in Budd - Chiari syndrome and alcoholic liver cirrhosis) mimic mp -HCC, and to differentiate the latter, T2 - weighted images of MRI may be useful.
新潟大学の論文