肝脏 ›› 2017, Vol. 22 ›› Issue (6): 505-508.

• 论著 • 上一篇    下一篇

慢性肝病背景微小肝癌的 MR诊断

胡海东,张见增,尤金涛,董景辉,安维民   

  1. 100039 北京 解放军第三○二医院放射科
  • 出版日期:2017-06-30 发布日期:2017-06-30
  • 通讯作者: 张见增,Email:zhzhjzjz@163.com
  • 作者简介:张见增,Email:zhzhjzjz@163.com

The MR diagnosis of micro hepatocellular carcinomas in patients with chronic liver disease

HU Hai-dong, ZHANG Jian-zeng, YOU Jin-tao,DONG Jing-hui, AN Wei-min   

  1. The Radiology Department of PLA 302 Hospital, Beijing 100039, China
  • Online:2017-06-30 Published:2017-06-30
  • Contact: ZHANG Jian-zeng, Email:zhzhjzjz@163.com

摘要: 目的 了解微小肝癌的MR特点,提高对微小肝癌的认识和早期诊断率。方法 收集整理慢性肝病背景患者病理及临床诊断的微小肝癌共50例(55癌灶),分析其MR平扫及动态增强各序列图像表现及复查变化。结果 各序列表现比较:DWI高信号病灶数所占比例为96.4%(53/55);T2WI高信号病灶数所占比例为76.4%(42/55);T1WI低信号病灶数所占比例为67.3%(37/55);双回波含脂质成分病灶数所占比例为14.5%(8/55);动态增强“快进快出”病灶数所占比例为67.3%(37/55);“快进慢出” 病灶数所占比例为32.7%(18/55);延迟期有假包膜强化病灶数所占比例为29.1%(16/55)。DWI与T2WI高信号病灶数所占比例差异有统计学意义(P=0.007)。所有病例2个月~2.5年内复查增大。结论 高场MR为目前微小肝癌最好的检查方法,应作为慢性肝病患者定期复查首选的影像检查。

关键词: 肝疾病, 肝细胞肝癌, 磁共振成像

Abstract: Objective To analyze the magnetic resonance (MR) manifestations of micro hepatocellular carcinoma (MHCC) retrospectively, and to improve the awareness and the early diagnostic rate of MHCC. Methods Fifty-five foci from 50 cases clinically and pathologically diagnosed of MHCC were collected, and the manifestations of scan and dynamic contrast-enhancement (DCE) in MR were also analyzed.Results Main MR manifestations were described as follows: foci with high signal in diffusion weighted imaging (DWI) and T2 weighted imaging (T2WI) accounted for 96.4% (53/55) and 76.4% (42/55), respectively, with significant difference (P=0.007). Rate of foci with low signal in T1 weighted imaging (T1WI) was 67.3% (37/55). Foci with lipids compositions in double echo was 14.5% (8/55). In DCE, 67.3% (37/55) foci appeared arterial hypervascularity and venous or delayed phase washout, while 32.7% (18/55) were with arterial hypervascularity and venous or delayed phase late washout. All neoplastic foci were enlarged in reexamination within 2 months to 2.5 years.Conclusion At present, 1.5/3.0T MR might be served as the best method for detecting MHCC, which should be preferred as the first choice in regular examination for patients with chronic liver disease.

Key words: Hepatopathy, Hepatocellular carcinoma, Magnetic resonance imaging