The diagnosis and clinical value of imaging for primary clear cell carcinoma of the liver

Abstract

Objective To investigate the imaging features of primary clear cell carcinoma of the liver (PCCCL) and its clinical value.Methods MRI and CT finding of 12 patients with PCCCL proved by pathology were analyzed retrospectively.8 patients underwent plain and dynamically enhanced MRI and 10 patients underwent plain and dynamically enhanced CT scanning.Results The numbers were 67％ (8/12) in the right lobe,25％ (3/12) in the left lobe,and 8％(1/12) in the caudate lobe.Tumor diameters were 1.6 to 9.8 cm,and the average was 3.6 cm.For the MRI examination,75 ％ (6/8) showed a mixed high signal on T2WI and an equal or slightly lower signal on T1WI.All of the signal was reduced on anti-phase T1WI,67 ％ (4/6)was obviously reduced,and all showed high signal on DWI.The 75 ％ (4/6) slightly enhanced at the arterial phase continued to enhance at the portal venous phase.The pathology confirmed that there was a higher proportion of clear cell.25 ％ (2/8) showed an equal signal on T2WI and a slightly higher signal on T1WI,all of the signal reduced on anti-phase T1WI,and all showed equal or slightly higher signal on DWI.All were significantly enhanced at the arterial phase and clearanced at the portal venous phase.The pathology confirmed that there was a relative lower proportion of clear cell.50％ (4/8) could be seen with the capsule and ring enhanced.All showed low-density on CT scan,80％ (8/10) were slightly enhanced at arterial phase and the signals continued to strengthen at the portal venous phase.The pathology confirmed that 75％ (6/8) had a higher proportion of clear cell and 25％ (2/8) had a relatively low proportion of clear cell.20％ (2/10) showed significantly uneven enhancement at the arterial phase and the degree of enhancement decreased at the portal venous phase.The pathology confirmed that there was a lower proportion of clear cell.20％ (2/10) could be seen with the capsule with the ring enhanced.Conclusions Plain and dynamically enhanced MRI and CT scans could show the pathological features and tissue composition of PCCCL fully and accurately.They were effective methods and each had certain characteristics.The combination of these had important values to diagnosis PCCCL and could provide important information for clinics to develop the best treatment plan and prognostic evaluation. Key words: Liver neoplasm; Clear cell carcinoma; X-ray computed; Magnetic resonance imaging