【摘要】 目的 探讨混合型肝癌(cHCC-CC)的临床特点及影像学表现特征。方法 对18例经手术病理证实的cHCC-CC病人的临床及影像学资料进行回顾性分析。结果 实验室检查乙肝表面抗原(HBSAg)阳性10例,丙肝表面抗体(HCVAb)阳性5例,AFP升高13例,CA19-9升高12例,CEA升高2例。影像学检查表现为5种强化方式,8例HCC为主型中4例表现为Ⅰ型(快进快出),2例表现为Ⅲ型(环形强化),10例CC为主型中3例表现为Ⅰ型,3例表现为CC常见的Ⅱ型(延迟强化)、Ⅲ型,1例Ⅴ型(无强化),2例HCC为主型及3例CC为主型表现为Ⅳ型(HCC和CC相混杂)的增强方式。结论 大部分cHCC-CC的影像学表现缺乏特征性,但HCC和CC相混杂的增强形式及结合AFP、CA19-9等实验室指标有助于提示本病的诊断。更多还原

【Abstract】 Objective To analyze the clinical and imaging characteristics of combined hepatocellular carcinoma and cholangiocarcinoma(cHCC-CC).Methods The clinical and imaging data from 18 patients with cHCC-CC were analyzed retrospectively.Results HBSAg was positive in 10 cases.HCVAb was positive in 5 cases.Elevated AFP,CA19-9 and CEA was found in 13,12 and 2 patients,respectively.Five enhancement patterns were observed in the HCC type,4 cases presented as type Ⅰ(an area of hyper-enhancement in the arterial phase and hypo-enhancement due to washout of contrast medium in the delay phase),2 cases presented as type Ⅲ(peripheral enhancement);in the CC type,3 cases presented as type Ⅰ,3 cases presented as type Ⅱ(delay enhancement),type Ⅲ which were common in CC.One case presented as type Ⅴ(no enhancement).Two HCC type and 3 CC type shows type Ⅳ enhancement pattern(mixed pattern of HCC and CC).Conclusion Most cHCC-CC had no characteristics on imaging,but the mixed enhancement pattern of HCC and CC,as well as combination of AFP,CA19-9,can be helpful in the diagnosis of cHCC-CC.更多还原