共查询到20条相似文献,搜索用时 12 毫秒
1.
Jing-Houng Wang Tsung-Ming Chen Hung-Da Tung Chuan-Mo Lee Chi-Sin Changchien Sheng-Nan Lu 《Journal of ultrasound in medicine》2002,21(7):767-72; quiz 773-4
OBJECTIVE: To determine with the use of color Doppler sonography whether bile duct tumor thrombi had detectable vasculature in hepatocellular carcinoma. METHODS: Among 491 patients with tissue-proven hepatocellular carcinoma, 9 (1.8%) had bile duct tumor thrombi. All 9 patients had spectral Doppler sonography guided by color Doppler sonography (3.75-MHz convex probe). RESULTS: All 9 patients had dilated bile ducts with isoechoic thrombi. Eight patients had tumors infiltrating into and obstructing adjacent major bile ducts. The other patient had common hepatic duct tumor emboli that were not adjacent to primary tumors. Color signals were detectable within bile duct tumor thrombi in 7 patients. All of them had pulsatile waveforms on spectral analyses. CONCLUSIONS: Bile duct tumor thrombosis with obstructive jaundice was a rare complication of hepatocellular carcinoma. A detectable color signal with pulsatile waveforms was shown in most cases by color Doppler sonography with spectral analyses. 相似文献
2.
Obstructive jaundice caused by hepatocellular carcinoma: detection by endoscopic sonography. 总被引:4,自引:0,他引:4
Y C Lee H P Wang S P Huang Y T Chang C T Wu C S Yang M S Wu J T Lin 《Journal of clinical ultrasound : JCU》2001,29(6):363-366
Tumor thrombus in the extrahepatic biliary tree is a rare mechanism of obstructive jaundice. We present a patient with a minute hepatocellular carcinoma in the caudate lobe that invaded the common hepatic duct and caused biliary obstruction. Endoscopic sonography showed a tumor thrombus with central echogenicity and a "nodule-in-nodule" pattern and suggested the correct diagnosis. 相似文献
3.
4.
乳腺导管内病变的声像图特征及分型 总被引:1,自引:0,他引:1
目的 探讨高频彩色多普勒超声对乳腺导管内病变的诊断价值.方法 对69例经手术病理证实的导管内病变患者的二维和彩色多普勒血流情况进行回顾性分析.根据二维声像图将乳腺导管内病变分为无导管扩张型(Ⅰ型)和扩张型(Ⅱ型).结果 69例患者共87个病灶,良性病灶71个,恶性病灶16个,超声与手术病理相符者66个,符合率75.86%;Ⅰ型42个病灶、Ⅱ型45个病灶.结论 高频探头近区干扰少,分辨率高,能清楚显示乳腺导管有无扩张及导管内肿块回声,结合彩色血流信息有助于病灶的发现及其良恶性的鉴别. 相似文献
5.
Ji Yeon Park Seong Yoon Yi Taejung Kwon Soo Heui Baek Seon-Jeong Kim Ki Eon Kwon Jiyoun Choi 《Journal of clinical ultrasound : JCU》2019,47(1):44-46
Metastasis to the thyroid is very rare in hepatocellular carcinoma (HCC) and only a few cases have been reported. Herein, we report a rare case of metastatic HCC to the thyroid in a 63-year-old man and discuss the various radiologic findings. Computed tomography (CT) revealed a heterogeneous enhancing mass that had invaded the thyroid cartilage in the left upper thyroid, compressing the airway. Ultrasonography (US) showed a heterogeneous hypoechoic mass with increased vascularity in the peripheral portion. The mass showed focal intense uptake on positron emission tomography-computed tomography (PET-CT). The patient underwent US-guided core needle biopsy and the final diagnosis was metastatic HCC. 相似文献
6.
目的 探讨磁共振扩散张量成像(DTI)鉴别肝内胆管细胞癌(ICC)和肝细胞癌(HCC)的价值。方法 回顾性分析在我院接受肝脏MR检查并经病理证实的ICC 20例(ICC组)、HCC 32例(HCC组)。所有患者均接受1.5T MRI常规T1WI、T2WI、DWI及DTI序列扫描,观察病变影像学特征。由2名观察者独立测量两组病灶DTI的弥散系数(D)值、各向异性分数(FA)值及DWI的ADC值,分析其测量的一致性并进行组间比较。对有统计学差异的参数,绘制ROC曲线,分析诊断效能及阈值。结果 ICC组9例(9/20,45.00%)病灶边界清晰,HCC组15例(15/32,46.88%)边界清晰,差异无统计学意义(χ2=0.02,P=0.90)。ICC组11例(11/20,55.00%)可见邻近胆管扩张,高于HCC组(4/32,12.50%),差异有统计学意义(χ2=10.83,P=0.001)。2名观察者测得的2组各参数结果一致性良好,相关系数值均大于0.90。ICC组FA值(0.45±0.16)高于HCC组(0.30±0.13),差异有统计学意义(P=0.001);2组的ADC值和D值差异均无统计学意义(P均>0.05)。FA值ROC曲线下面积为0.76,在界值为0.31时,鉴别诊断ICC与HCC的敏感度(85.0%)较高。结论 DTI的FA值对鉴别ICC与HCC有较高的诊断效能,可以为临床提供重要参考。 相似文献
7.
目的 观察肝内胆管肉瘤样癌(SICC)的临床病理、免疫表型和预后特征.方法 对16例SICC的临床病理特征、免疫表型进行观察,并结合文献探讨该肿瘤的病理诊断和鉴别诊断.结果 16例患者中男性15例,女性1例,年龄35 ~72岁,中位年龄51岁.临床主要表现为腹痛及局部肿块,病变部位以右叶为主,呈浸润性生长.镜下见胆管癌细胞由不同分化程度的腺癌细胞组成,肉瘤样成分按其形态特征分为梭形细胞型、巨细胞型和多种肉瘤分化.免疫组化示肿瘤细胞CK19和vimentin(+),HepPar 1和AFP(-),并表达多种间叶分化性标记.16例均行术后随访,中位生存时间为6个月.结论 肝内胆管肉瘤样癌为见高度恶性的上皮性肿瘤,组织学结构复杂,表现为多种成分并存,肿瘤细胞CK19和vimentin(+),HepPar 1和AFP(-)模式具有重要诊断价值. 相似文献
8.
Kim KW Kim SH Kim MA Lee JM Park HS Kim JY Lee JY Han JK Choi BI 《Abdominal imaging》2009,34(2):217-224
Background
To retrospectively analyze computed tomography (CT) features of adenosquamous carcinoma (ASC) of the extrahepatic bile duct
and to correlate them with pathologic findings.
Methods
Six patients who underwent radical surgical resection for ASC of extrahepatic bile duct were included. CT and pathologic findings
were analyzed and correlated with each other.
Results
Five ASCs were periductal infiltrative type and the remaining one was intraductal polypoid type. Histologically, ASC was composed
of squamous and glandular components which mixed in an intermingled pattern and was characterized by a high local aggressiveness
mainly due to the squamous component. The most common CT findings were a segmental wall thickening with delayed enhancement.
Overall, CT features were well correlated with pathologic findings. However, CT tended to underestimate radial extent of the
tumor compared with histologic findings.
Conclusions
Histopathologically, ASC of the extrahepatic bile duct is characterized by greater local aggressiveness. However, their CT
findings are not quite different from those of usual adenocarcinoma due to the unique geographic characteristic of being located
at a very limited space. 相似文献
9.
Spontaneous necrosis of hepatocellular carcinoma (HCC) is rare. We report the case of a 72-year-old woman with an HCC nodule that underwent necrosis after sonographically guided needle biopsy. Baseline sonographic examination revealed only a nonspecific change in the echogenicity of the lesion. Subsequent necrosis was suggested on contrast-enhanced sonographic examination and was confirmed on spiral CT. 相似文献
10.
Three-dimensional power Doppler imaging in depicting vascularity in hepatocellular carcinoma. 总被引:8,自引:0,他引:8
Hui-Xiong Xu Li Liu Ming-De Lu He-Ping Li Guang-Jian Liu Jia-Ping Li 《Journal of ultrasound in medicine》2003,22(11):1147-1154
OBJECTIVE: To assess the ability of three-dimensional power Doppler imaging to depict vascularity in hepatocellular carcinoma. METHODS: Forty-three patients with hepatocellular carcinomas were subjected to two- and three-dimensional power Doppler imaging, and 14 of them also underwent angiography. The delineated amounts of intratumoral Doppler signals were compared between 2 methods of power Doppler imaging in 43 patients. In the 14 patients who also underwent angiography, the patterns of blood supply depicted by 2 methods of power Doppler imaging were compared with that depicted by angiography, and the intratumoral vascularity on three-dimensional projection images and angiograms was also quantitatively assessed by calculating the vascularity-area ratio with graphics software. RESULTS: In comparison with two-dimensional power Doppler imaging, three-dimensional power Doppler imaging was subjectively determined as showing more intratumoral Doppler signals in 32 (74.4%) of the 43 lesions. The accuracies in depicting vascular patterns were 64.3% (9 of 14) for three-dimensional projection images and 14.3% (2 of 14) for two-dimensional slices compared with the results of angiography. The vascularity-area ratios on three-dimensional power Doppler imaging projections and angiograms were 46.0% +/- 25.6% and 48.5% +/- 22.5% (mean +/- SD), respectively (P > .05). Three-dimensional projection images correlated significantly with angiograms in quantifying the vascularity (gamma = 0.87; P < .001). CONCLUSIONS: A three-dimensional power Doppler projection image gives a better overall picture of vascular distribution than a two-dimensional slice and correlates with angiography significantly for delineating vascularity in hepatocellular carcinoma. 相似文献
11.
目的:探讨血清总胆汁酸对于肝细胞肝癌(简称肝癌)患者的预后意义。方法:收集145例肝癌患者的临床资料并随访其生存期,比较总胆汁酸升高组和正常组两组患者之间临床因素的差异,通过单因素、多因素分析影响肝癌患者总生存期的预后因素。结果:高胆汁酸组患者在多个肝功能指标上与正常胆汁酸水平组患者存在显著差异,血清总胆红素17.1μmol/L(22.6%vs 7.2%)、白蛋白35 g/L(32.3%vs 7.2%)、GGT70 U/L(59.7%vs 39.8%)、PT14 s(27%vs 7.2%)的患者比例明显高于正常胆汁酸水平患者(P0.05)。多因素分析结果显示:总胆汁酸10μmol/L(HR=1.595,P=0.029)、有门静脉侵犯(HR=2.102,P=0.005)、有远处转移(HR=1.922,P=0.035)是影响肝癌患者总生存期的独立危险因素。结论:总胆汁酸是影响肝癌患者预后的独立危险因素。 相似文献
12.
幽门螺杆菌感染与原发性肝癌的相关性研究 总被引:2,自引:0,他引:2
目的研究幽门螺杆菌(Hpylori)感染与原发性肝癌的关系以及其在原发性肝癌发生中的作用机制。方法分别采用碳-14呼气法和ELISA法检测原发性肝癌患者及健康体检者的幽门螺杆菌感染情况和幽门螺杆菌抗体(Hp—CagA—IgG)。结果原发性肝癌患者的幽门螺杆菌感染率明显高于健康体检者。结论幽门螺杆菌感染与原发性肝癌有明显的相关性。 相似文献
13.
目的探讨乳腺导管内乳头状癌的临床病理特征、诊断与治疗要点.方法对15例乳腺导管内乳头状癌进行临床病理特性分析,结合文献对其临床表现、诊断和治疗原则进行探讨.结果15例乳腺导管内乳头状癌主要表现为乳腺局部肿块或伴乳头溢血,影像学检查表现为扩张导管内不规则实性中低回声光团,部分病灶内可见沙粒样钙化点.免疫组化 SMA 、Calponin 和 p63显示肌上皮缺如或不连续;高相对分子质量细胞角蛋白 CK5/6在癌组织未见表达.结论乳腺导管内乳头状癌是一种低度恶性肿瘤,预后较好.单纯乳腺导管内乳头状癌或伴导管内原位癌彻底切除肿瘤及其周围部分乳腺组织已属充分治疗,伴微浸润者宜按照浸润性导管癌治疗. 相似文献
14.
Manabu Morimoto Akinori Nozawa Kazushi Numata Kazuhito Shirato Kazuya Sugimori Atsushi Kokawa Naohiko Tomita Toshifumi Saitou Yukio Nakatani Toshio Imada Katsuaki Tanaka 《Journal of ultrasound in medicine》2005,24(3):273-283
OBJECTIVE: To evaluate the usefulness of contrast-enhanced harmonic wideband gray scale sonographic images obtained after radio frequency-induced coagulation necrosis, we compared the morphologic and histopathologic characteristics of the ablated tumors with sonographic images of the tumors. METHODS: Forty-eight patients with 72 hepatocellular carcinomas with a maximal diameter of 3 cm or less were treated percutaneously using radio frequency ablation. Six treated tumors in 4 patients were resected 1 month after ablation; the remaining 66 treated tumors were evaluated by a biopsy procedure performed with an 18-gauge fine needle 1 month after ablation. The excised tumors and biopsy specimens were then examined by histopathologic methods, and the findings were compared with those obtained on contrast-enhanced harmonic wideband gray scale sonography. Hematoxylin-eosin-stained specimens were inconclusive as to whether cellular viability remained; therefore, cell viability was determined by a positive result after histochemical (lactate dehydrogenase and nicotinamide adenine dinucleotide phosphate-diaphorase) staining. RESULTS: Contrast-enhanced harmonic wideband gray scale sonography after radio frequency ablation showed residual tumor enhancement in 5 (6.9%) of the 72 tumors; the histopathologic results for these 5 tumors were also positive for tumor residue. The remaining 67 tumors (93.1%) did not show any residual tumor enhancement when examined by sonography; however, only 66 tumors did not reveal tumor residue when examined histopathologically. Contrast-enhanced harmonic wideband sonographic imaging provided results that were comparable with histopathologic findings, the criterion standard for diagnosis; the sensitivity and specificity of the sonographic images for the detection of residual tumor tissue in ablated tumors were 83.3% (5 of 6) and 100% (66 of 66), respectively. CONCLUSIONS: Contrast-enhanced harmonic wideband gray scale sonography is a potentially useful technique for evaluating the therapeutic effects of radio frequency ablation on hepatocellular carcinoma. 相似文献
15.
Sung Hee Mun Eun Young Ko Boo-Kyung Han Jung Hee Shin Suk Jung Kim Eun Yoon Cho 《Journal of ultrasound in medicine》2008,27(6):947-954
OBJECTIVE: The purpose of this series was to evaluate the sonographic features of secretory carcinoma of the breast. METHODS: Between 1994 and 2006, 9 patients had histologically confirmed secretory carcinoma of the breast in our institution, and 6 of them underwent breast sonography. We retrospectively evaluated the sonographic findings of the patients in correlation with other available images and reviewed the clinical records. RESULTS: Clinical manifestations were a palpable mass (n=3), a bloody nipple discharge (n=1), and screening-detected abnormalities (n=2). Breast sonograms showed masses with a round or oval (n=5) or tubular (n=1) shape, with relatively well-circumscribed (n=2) or partially microlobulated (n=4) margins, and with a hypoechoic (n=4) or an isoechoic (n=2) internal echo texture. Most lesions were single nodules (n=3) or groups of nodules (n=2) measuring 1 cm or smaller, except 1 mass measuring 3.5 cm with axillary lymph node metastasis. Two cases had associated ductectasia. Sonographic assessments were classified as Breast Imaging Reporting and Data System category 3 in 2 cases, category 4A in 3 cases, and category 4B in 1 case. CONCLUSIONS: Secretory carcinoma of the breast is frequently shown as a small benign-looking nodule or group of nodules or sometimes as an intraductal lesion with a low clinical stage on sonography. Although secretory carcinoma is a rare breast malignancy, awareness of its sonographic features will be helpful for the differential diagnosis. 相似文献
16.
Kazushi Numata Manabu Morimoto Takashi Ogura Kazuya Sugimori Shigeo Takebayashi Masahiro Okada Katsuaki Tanaka 《Journal of ultrasound in medicine》2008,27(3):395-406
OBJECTIVE: We evaluated the usefulness of contrast-enhanced harmonic gray scale sonography with a newly developed sonographic contrast medium as a means of guidance for percutaneous ablation therapy of hepatocellular carcinoma lesions not detected by conventional sonography. METHODS: We examined 85 patients with 108 hepatocellular carcinoma lesions that were identified as hypervascular by multidetector-row computed tomography by using contrast-enhanced harmonic gray scale sonography after injection of Sonazoid (GE Healthcare, Oslo, Norway), a lipid-stabilized suspension of a perfluorobutane gas microbubble contrast agent. We scanned the whole liver by this modality at a low mechanical index in the late phase to detect lesions not detected by conventional sonography and then scanned the lesions again by this modality at a high mechanical index to visualize tumor vessels and enhancement. We also performed percutaneous ablation therapy guided by this modality to treat viable hepatocellular carcinoma lesions that could not be detected by conventional sonography. RESULTS: Conventional sonography identified 90 (83%) of 108 hepatocellular carcinoma lesions; 15 (14%) additional viable lesions not detected by conventional sonography were detected in the late phase of contrast-enhanced harmonic gray scale sonography at a low mechanical index, and tumor vessels and enhancement were observed in the late phase at a high mechanical index. Contrast-enhanced harmonic gray scale sonography diagnosed 105 (97%) of the 108 viable hepatocellular carcinoma lesions, and 14 (93%) of the 15 lesions not detected by conventional sonography were successfully treated by percutaneous ablation therapy guided by this modality. CONCLUSIONS: Contrast-enhanced harmonic gray scale sonography is useful for guidance of percutaneous ablation therapy of hepatocellular carcinoma lesions not detected by conventional sonography. 相似文献
17.
MD Atsushi Hiraoka MD Teru Kumagi MD Tomoyuki Yokota MD Sachiko Utsunomiya MD Hiromi Ohtani MD Norio Horiike MD Morikazu Onji 《Current therapeutic research》2005,66(6):589-597
Background:
α-Fetoprotein (AFP) is a useful marker of hepatocellular carcinoma (HCC), and protein induced by vitamin K absence or antagonist II (PIVKA-II) and fucosylated AFP (AFP-L3) are specific tumor markers.Objective:
The aim of this article was to report a case of intrahepatic cholangiocarcinoma (CC) with high levels of expression of AFP, AFP-L3, and PIVKA-II.Methods:
A 70-year-old man weighing 66 kg with a diagnosis of intrahepatic CC presented with a liver tumor 4.0 cm in diameter and elevated concentrations of carbohydrate antigen 19-9 (575 U/mL), PIVKA-II (379 mAU/mL), and AFP (497 ng/mL; AFP-L3, 88.1%). On extended medial hepatic segmentectomy, microscopy showed that the tumor was a CC without HCC. The patient subsequently underwent immunohistochemical assessments using cytokeratin-19, epithelial membrane antigen (EMA), hepatocyte paraffin-1 (HP-1), PIVKA-II, and AFP.Results:
In all specimens, desmoplasia was observed. However, results of immunohistochemistry showed positive results for cytokeratin-19 and EMA; HP-1 results were negative. Results of PIVKA-II and AFP testing in the tumor were positive.Conclusions:
The case presented here showed characteristics of CC and HCC, whereas the histologic expression of the tumor suggested CC. Based on the literature search, this is the first known report of a case of a CC expressing AFP and PIVKA-II confirmed on immunohistochemical staining. This case is interesting with regard to the ability of the progenitor cells to differentiate HCC and CC. 相似文献19.
目的研究探讨术前体质量指数(BMI)对肝细胞性肝癌术后预后的影响。方法回顾性分析了1998~2005年105例肝细胞性肝癌术后的体质量指数资料,按BMI将患者分为低体质量、正常、高体质量和肥胖4组。采用生存分析对不同体质量指数组患者术后的预后进行综合比较分析。结果与正常体质量组相比,低体质量组的甲胎蛋白水平、肿瘤大小、分化程度在死亡风险、肿瘤再发及转移上的差异有显著性(P<0.01)。单因素生存分析结果表明低体质量组的总体生存率有显著的下降(P<0.001)。多因素预后分析显示体质量指数、肿瘤大小、肿瘤分级和甲胎蛋白水平可以做为判断预后的独立因素(P<0.05)。结论低体质量组患者的总体生存率、无再发和无转移生存时间有明显的下降。体质量指数分级是判断原发性肝癌术后预后的一个独立因素。 相似文献
20.