Eur Radiol:没有“快进快出”的肝细胞肝癌到底是为什么?

2021-01-24 shaosai MedSci原创

肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。动态增强CT和MRI对HCC高风险人群的筛查、诊断具有重要价值。

     肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。动态增强CT和MRI对HCC高风险人群的筛查、诊断具有重要价值。根据HCC的血供特点,依靠病灶的强化方式——动脉期明显强化,随即出现强化廓清便能够进行诊断。

     强化廓清是HCC诊断的一项重要特点,是指肝脏病灶在门静脉期或延迟期出现了强化程度较动脉期的减低。然而,遇到的HCC的强化廓清程度不一。在临床工作中,放射科医师多为主观地评价肿瘤-肝实质强化对比程度,它不但受病灶血管的影响,而且还受肝脏实质背景的血流动力学情况。

     近期研究表明,HCC发生率与肝脏脂肪变性性病变具有相关性,如非酒精性脂肪肝(NAFLD)。由于脂肪变性的存在,肝实质背景在CT上密度减低,这便造成了CT上典型的廓清现象消失!同时,动态增强MRI检查中采用了压脂技术减少了脂肪变性对病灶强化变化的影响。那利用CT和MRI对评价有无背景脂肪肝存在的情况下,HCC的诊断及强化廓清征象的检出效果如何呢?


     近日,Eur Radiol上发表的一篇名为Vanishing washout of hepatocellular carcinoma according to the presence of hepatic steatosis: diagnostic performance of CT and MRI的论文利用探讨脂肪肝的存在是否会影响强化廓清征象及计算机断层扫描(CT)和磁共振成像(MRI)对肝细胞癌(HCC)的诊断价值。

     该回顾性研究纳入了566例慢性肝病患者,这些患者在2016年1月至2018年6月之间因肝肿瘤行肝切除术(482例HCC和84例非HCC),分析患者动脉增强CT和MR图像。根据肝脂肪变性的存在与否,将患者分为脂肪肝(n = 141)或非脂肪肝(n = 425)组,在病理检查中,肝脂肪变性定义为至少5%肝细胞中的存在脂质滴。比较两组之间HCC强化廓清的存在以及CT和MRI对HCC的诊断性能。图.研究流程图

       研究结果发现,在CT上,脂肪肝组中的HCC强化廓清发生率低于非脂肪肝组(61.5%对88.9%,p <0.001),而在MRI上,两组表现相似(77.0%对 74.4%,p = 0.565)。在CT上, 脂肪肝组对于肝癌诊断的敏感性(53.3%vs. 80.0%,p <0.001)和准确性(53.9%vs. 80.9%,p <0.001)显著低于非脂肪肝组。 但是,在MRI上,这些值在各组之间无显著统计学差异(p> 0.05)。

图.59岁肝细胞肝癌并轻度脂肪肝的男性患者,CT上强化廓清征象模糊,MRI上强化廓清征象存在

图.60岁肝细胞肝癌并中度脂肪肝的男性患者,CT上强化廓清征象消失,MRI上强化廓清征象存在

     本研究结果表明,肝脂肪变性会降低正常肝实质背景密度,从而影响了强化廓清征象的出现,继而降低了CT诊断HCC的能力;由于动脉增强MRI扫描中采用了压脂技术,肝脂肪变性的存在并不会影响MRI对HCC的诊断。


写在后面

     对于放射科医师来说,对于病灶的诊断多是依赖于病变的典型征象,就像肝细胞肝癌中的“快进快出”,这是进行肝细胞肝癌诊断具有价值的征象之一。然而,在实际工作中,如果并没有“快进快出”这一征象,那诊断肝细胞肝癌的把握就会大大降低。哪怕是其他征象再可疑,大胆的放射科医师也会下一个不典型肝癌可能性大,建议穿刺活检。本研究分析了强化廓清征象消失的原因,明确了不典型影像学表现的肝细胞肝癌的影响因素,这会很好地解决了临床中对于肝脏病变诊断的困惑!


原始出处:

Ji Hye Min,Tae Wook Kang,Yeon-Yoon Kim,et al. Vanishing washout of hepatocellular carcinoma according to the presence of hepatic steatosis: diagnostic performance of CT and MRI.PMID:33159576DOI:10.1007/s00330-020-07438-9

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (8)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-04-23 胰生肝

    学习了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-06-12 xjy02
  3. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-02-03 Aidy

    肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-01-30 ms7000000982141651

    谢谢啦

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-01-26 1257c336m18暂无昵称

    我为。。。而来

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-01-24 留走人康

    肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=959848, encodeId=f3ef959848f7, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201012/dbb5a26e62614536819f04769a918373/aaaa581a1bad48438359ebf0427bfea2.jpg, createdBy=cb855425012, createdName=胰生肝, createdTime=Fri Apr 23 18:33:54 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1863535, encodeId=8901186353571, content=<a href='/topic/show?id=c0b68135561' target=_blank style='color:#2F92EE;'>#肝细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81355, encryptionId=c0b68135561, topicName=肝细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d59291, createdName=xjy02, createdTime=Sat Jun 12 15:10:27 CST 2021, time=2021-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=922615, encodeId=3fc1922615cc, content= 肝细胞肝癌(HCC)的定性诊断较大程度地无需活检,单纯依靠影像学特点便能够达到定性诊断。, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c8585442638, createdName=Aidy, createdTime=Wed Feb 03 23:02:01 CST 2021, time=2021-02-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=921445, encodeId=720692144526, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210130/f777d0b91a25425ba588babbf050d6d1/328b4c90fd7741d090ece3b8f155fc70.jpg, createdBy=25525455713, createdName=ms7000000982141651, createdTime=Sat Jan 30 21:07:15 CST 2021, time=2021-01-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920159, encodeId=5ec0920159bd, content=我为。。。而来, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01f52568974, createdName=1257c336m18暂无昵称, createdTime=Tue Jan 26 23:00:27 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1040346, encodeId=01e9104034610, content=肝癌,接下来就要细分了,对于体质好的病人,能否将PD-1类+抗血管新生+放疗等相结合,甚至有必要用TACE进行减负, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=留走人康, createdTime=Sun Jan 24 14:10:27 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919421, encodeId=7b879194216c, content=<a href='/topic/show?id=96db81369c7' target=_blank style='color:#2F92EE;'>#肝细胞肝癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81369, encryptionId=96db81369c7, topicName=肝细胞肝癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sun Jan 24 11:26:25 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=919418, encodeId=8a389194183e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201204/049b07eb9838407a9de80d92834eede1/04596ea802e342bfaba196f9604cb91c.jpg, createdBy=11325430649, createdName=ms3000001340106445, createdTime=Sun Jan 24 11:13:29 CST 2021, time=2021-01-24, status=1, ipAttribution=)]
    2021-01-24 ms3000001340106445

    学习了

    0

相关资讯

Euro Radio:利用CT纹理分析来发现肝细胞肝癌TACE治疗后的反应!

研究基于肿瘤大小和治疗前CT纹理参数的嵌套多参数决策树模型准确预测肝癌对经导管动脉化疗栓塞术(TACE)反应的可行性。

Eur Radiol:慢性过敏性肺炎患者CT表现的动态变化预测纤维化进展及急性加重

慢性过敏性肺炎患者CT表现的动态变化预测纤维化进展及急性加重

专注“中国“质”造 赛诺威盛助力国产CT自主创新再提速

CT作为医学诊断中不可或缺的医用大型诊断设备,一方面随着我国社会经济的快速发展和公众医疗服务需求的不断升级,另一方面,随着分级诊疗、医联体建设的深入推进,以及“国产替代进口器械&rdquo

Br J Cancer:计算机断层扫描(CT)相比于胸透(CXR)在妊娠滋养细胞瘤形成的初步评估中并无优势

妊娠滋养细胞肿瘤(GTN)通常采用国际妇产科联合会(FIGO)评分系统进行分类,以鉴定患者属于单药化疗耐药(SACR)的低风险(得分≤6)或高风险(得分≥7)。

Eur Radiol:如何预测慢性过敏性肺炎患者不会呼吸的痛——肺间质纤维化?

过敏性肺炎具有各种各样的临床进展类型,如何预测患者临床发病进展及纤维化风险是非常有挑战性的,但这种挑战不是没有可能完成的!

Eur Radiol: 想准确地检出CT中的肋骨骨折,又不想看瞎眼,那有什么好办法吗?

     放射科医师的眼是保住工作的铁饭碗,然而,有些工作偏偏想砸了他的铁饭碗!