肝硬化背景下小肝细胞癌的诊断与鉴别诊断

Q3 Medicine
L Chen, S W Lu, T D Xiang, Y X Yu, W F Zhao
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引用次数: 0

摘要

在中国,大多数肝癌患者在确诊时已进展到中晚期,因此早期诊断是改善预后的重要关键。小肝细胞癌(sHCC)进一步分为早期HCC (eHCC)和晚期HCC (pHCC),肿瘤直径与患者预后显著相关。“快进快出”增强模式是肝癌显像(CECT/CEMRI/CEUS)的典型特征;然而,eHCC直径为
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Diagnosis and differential diagnosis of small hepatocellular carcinoma in the context of cirrhosis].

In China, most patients with hepatocellular carcinoma (HCC) have progressed to the middle and advanced stages when they are diagnosed, so early-stage diagnosis is a significant key to improving the prognosis. Tumor diameter significantly correlates with the prognosis of patients with small hepatocellular carcinoma (sHCC), which is further classified as early-stage HCC (eHCC) and advanced HCC (pHCC). The "fast in and fast out" enhancement pattern is a typical feature of liver cancer imaging (CECT/CEMRI/CEUS); yet, eHCC with a diameter of <2 cm frequently exhibits hypovascularity. Hepatocyte-specific enhanced MRI (EOB-MRI) displays a unique hepatobiliary-specific phase (HBP) hypointensity, along with atypical manifestations such as lipid-containing nodules, T2 hyperintensity, and restricted diffusion. HBP is a functional radiographic imaging feature for cancerous nodules in cirrhosis. EOB-MRI can significantly increase the hypovascularity detection rate of eHCC in conjunction with serologic markers like alpha-fetoprotein. With a focus on the dynamic changes in hypovascular hypointense nodules in HBP (including diameter size, APHE, DWI, and other parameters), it is recommended that high-risk cirrhotic cohorts undergo routine monitoring (EOB-MRI follow-up every three months) to diagnose early-stage eHCC, based on the existing evidence-based medicine. This recommendation in clinical practice guidelines provides a crucial strategy that can markedly enhance patients' five-year survival rates.

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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
7574
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