肝硬化结节癌变的早期影像诊断北京肝硬化治疗医院素材.ppt

T2WI低信号，T1WI高信号能除外HCC ? 病理：高分化HCC * T1WI T2WI 动脉期 门脉期 平衡期 肝癌都快进快出吗？ * 动脉期 门脉期 平衡期 HE染色 肝癌都快进快出吗？ * A nodule-in-nodule-type (NIN) hepatocellular carcinoma (HCC) in a dysplastic nodule. (a) Cut surface of lesion shows a typical nodule in nodule lesion. A dysplastic nodule (1.1cm in diameter, black arrow) surrounded a small HCC (0.8 cm in diameter, red arrow), which occupies almost the entire nodule with a remaining crescent-shaped dysplastic nodule at the periphery. (b) Light-microscopic features of NIN reveal (point a) cirrhotic lesion, (point b) dysplastic lesion and (point c) grade 1 HCC. (c) A border between a dysplastic lesion (point b) and a cirrhotic nodule (point a). This dysplastic lesion, classified as a high-grade dysplastic nodule because the lesion reveals small cell changes with nuclear crowding, increased the cell density but less than twice normal and showed anisocytosis with hyperchromatic nuclei. (d) The lesion was classified as grade 1 HCC and was composed of small acidophilic cancer cells. Note the nuclear density was more than twice that of the neighboring cirrhotic area. * Microscopic findings of type A and type B hepatocellular carcinomas (HCC). A: Type A hepatocellular carcinoma, overt welldifferentiated hepatocellular carcinoma in the right (HCC). Lesion of the left is diagnosed dysplastic lesion composed of small hepatocytes increased nuclear cytoplasmic ratio, not enough to diagnose hepatocellular carcinoma (dysplastic lesion). B: Type B hepatocellular carcinoma. Well differentiated hepatocellular carcinoma with replacing growth (HCC). No dysplastic lesion is recognized normal: normal liver. J. Surg. Oncol. 2005;92:100–103 * 北京京科肝泰医院 肝硬化结节癌变的早期影像诊断 概 要 肝硬化结节与肝细胞癌的发生 肝硬化的MRI检查技术 各种肝硬化结节的典型影像学表现 肝硬化结节癌变的早期影像学表现 * 一、肝硬化结节与HCC的发生 * 肝硬化相关的结节病变 再生结节（RN） 不典型增生结节（DN） 低级DN 高级DN 肝细胞癌（HCC） 高分化HCC 中分化HCC 低分化HCC 其他偶发伴随结节 FNH等 * Efremidis SC, et al. Eur Radiol 2002; 12:753 * Suk Woo Nam, et al. European Journal of Gastroenterology Hepatology 2006, 18:239