摘要
目的分析肝细胞癌（HCC）在MRDWI与动态增强成像中的影像表现。方法回顾性分析81例经病理或随访证实，且接受了DWI和Gd—DTPA动态增强检查的HCC患者资料，对所有结果进行分析。分别记录病变的数量和部位，统计分析DWI和Gd—DTPA动态增强图像中肝脏病变的信号表现。结果在81例患者中，DWI及Gd—DTPA动态增强检查共发现122个HCC和14个良性病变。122个HCC中，116个（95．1％）在DWI图像上表现为高信号，6个表现为等信号，这6个HCC都有严重的肝硬化背景。T1WI平扫图像上，105个（86．1％）为低信号，11个（9．0％）为等信号，6个（4．9％）为高信号。在Gd—DTPA动态增强的动脉期有101个（82．8％）明显强化，其中99个门静脉及平衡期表现为低信号；20个（16．4％）动脉期表现为等信号，在DWI均表现为高信号，20个HCC中有18个直径〈20mm。14个良性病变中8个在DWI图像上表现为高信号，6个为等信号。T1WI平扫图像上，5个表现为低信号，各期无强化，在DWI表现为高信号。6个平扫等信号，增强后明显强化，门静脉及平衡期表现为等信号，DWI上表现为等信号；2个T1WI平扫等信号的病变，各期增强仍然呈等信号，DWI表现为高信号，其中1个病理证实为再生结节。1个肝硬化再生结节T1WI平扫及DWI均为高信号，动脉期明显强化，门静脉及平衡期为等信号。结论多数HCC在MR动态增强图像上表现为动脉期明显强化，部分小HCC可表现为等信号。Gd—DTPA动态增强与DWI结合可能有助提高HCC的诊断准确性。
Objective To evaluate the findings of hepatocellular carcinoma （HCC） on DWI and dynamic Gd-DTPA-enhanced MR imaging. Methods Eighty one patients with chronic hepatitis or liver cirrhosis underwent both DWI and dynamic Gd-DTPA-enhanced MRI studies of the liver for HCC detection. MR data of were retrospectively analyzed. Two observers determined in consensus the location and the number of focal lesions. The signal manifestation of the lesions on DWI and dynamic Gd-DTPA-enhanced MR imaging were analyzed. Results DWI and Gd-DTPA-enhanced MR images detected 122 HCCs and 14 benign lesions. One hundred and sixteen HCCs（95. 1% ） showed hyperintensity on DWI and 6 HCCs in patients with severe cirrhosis showed isointensity. One hundred and five HCCs （86. 1% ） revealed hypointensity, 11 HCCs （9.0%） showed isointensity and 6 HCCs （4. 9% ） exhibited hyperintensity on T1 weighted images. On Gd-DTPA-enhanced MR images, 101 HCCs（82. 8% ） were significantly enhanced on arterial phase and 99 HCCs showed hypointensity on portal and equilibrium phases. Twenty HCCs （ 16.4% ）, 18 of 20 less than 20 mm in diameter, showed isointensity on arterial phase and hyperintensity on DWI. Eight of 14 benign lesions showed hyperintensity and 6 isointensity on DWI. Five benign lesions with hypointensity on T1 weighted images without contrast and hyperintensity on DWI showed no enhancement on Gd-DTPA-enhanced MR images; 6 benign lesions with isointensity on both T1weighted imaging without contrast and DWI exhibited avid enhancement on arterial phase and isointensty on portal and equilibrium phases ; one of the two benign lesions, with isointensity before and after contrast images and hyperintentiy on DWI, was a regenerative nodule; another regenerative nodule with hyperintensity on both T, weighted images without contrast and DWI was greatly enhanced on arterial phase and showed isointensity on portal and equilibrium phases. Conclusions Most of the HCCs were greatly enhanced on arterial phase on Gd-DTPA- enhanced MR imaging and some smaller HCCs showed isointensity on arterial phase and hyperintensity on DWI. The combination of DWI and Gd-DTPA-enhanced MR imaging may help to accurately diagnose HCCs.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2009年第8期822-826,共5页
Chinese Journal of Radiology
基金
国家自然科学基金资助项目（30670590）
关键词
肝肿瘤
磁共振成像
弥散
Liver neoplasms
Diffusion magnetic resonance imaging
