摘要
目的:探讨肝血管瘤和肝细胞癌在MR DWI和LAVA动态增强上的表现特征。方法:回顾性分析有完整临床资料,经手术病理或临床证实的肝血管瘤18例,肝细胞癌17例,共35例病例的MRI图像,随机选取37个病灶,其中肝血管瘤20个病灶、肝细胞癌17个病灶,同时选取20例无肝脏病变者的正常肝组织。扫描序列为常规自旋回波序列(T2WI、正反相位)、LAVA动态增强序列及DWI检查(b值分别为0和500s/mm2),对病灶DWI的信号及LAVA增强扫描特点进行分析,并对病灶及正常肝组织的ADC值进行测量,比较是否有差异。结果:多数(15/20)肝血管瘤病灶在DWI上表现为稍高信号,多数(14/17)肝细胞癌病灶表现为高信号,两者信号特点分布差异有统计学意义(P<0.05);正常肝组织的平均表观扩散现象(ADC)值为(1.16±0.12)×10-3mm2/s,肝血管瘤平均ADC值为(2.03±0.15)×10-3mm2/s,明显高于肝细胞癌的平均值(1.42±0.16)×10-3mm2/s(P<0.05)。20个肝血管瘤病灶LAVA动态增强表现出两种方式,15个(15/20,75.0%)病灶呈动脉期病灶边缘结节状明显强化,门静脉期及延时期强化向心性充填;5个(5/20,25.0%)病灶呈动脉期均匀强化,门静脉期和延迟期稍高于或等于肝实质。而17个肝细胞癌病灶LAVA动态增强表现出两种方式,14个(14/17,82.4%)病灶动脉期明显强化,门静脉期及延时期强化消退,强化表现为"快进快出";3个(3/17,17.6%)病灶于动脉期未见明显强化,门静脉期及延迟期轻度强化。11个(11/17,64.7%)肝细胞癌病灶显示完整的假包膜,且于门静脉期及延迟期强化。结论:DWI结合LAVA技术对肝血管瘤和肝细胞癌的鉴别诊断具有重要的临床应用价值。
Objective：To assess expression of liver hemangi0ma and hepatocellular carcinoma in diagnosis of DWI and LAVA dynamic enhanced MRI. Methods：The study was consisted of 18 cases of haemangiomas, 17 cases of hepatocellular carcinoma including 37 lesions, who has complete clinical data and were identified by operation or clinical pathology, and 20 persons had normal liver. Scanning Sequences were conventional spin echo sequence （T2WI,in phase and out of phase）,LAVA and DWI （b = 0.500 s/mm2）. We assessed the signal of the lesions on DWI and LAVA enhances scanning sequences, and measured the ADC values of the normal liver tissue and the lesions. Results：15 of 20 liver hemangioma lesions and 14 of 17 hepatocellular carcinoma lesions suggested a slight high signal and high signal on DWI respectively （ P 〈 0.05 ）. The average ADC values of normal liver tissue is （1.16 ±0.12） ×10-3mm2/s, and （2.03 ±0.15） ×10-3mm2/s for liver hemangioma, which is obviously high- er than that for （1.42 ±0.16） ×10-3mm2/s hepatocellular carcinoma （P 〈0.05）. In expression of LAVA dynamic enhance in 20 cases of liver hemangioma lesions, 15 lesions （75.0%） had edge nodular enhancement in arterial phase, and centripetal filling in the portal vein period and the delay period, remain had homogeneous enhancement in arterial phase; and in 17 cases of hepatocellular carcinoma, LAVA dynamic focal enhance in 14 lesions （82.4%） obviously strengthened in the arterial phase, and the strengthen as＂fast forward and out＂, no obvious strengthening for 3 lesions （ 17.6% ） in arterial phase. 11 of 17 hepatoceUular carcinoma showed the whole pseudocapsule and strengthening in the portal vein period and the delay period. Conclusions： DWI combined with LAVA technology has important value of clinical application on the differential diagnosis of liver hemangioma and hepatocellular carcinoma.
出处
《青海医药杂志》
2011年第12期4-8,共5页
Qinghai Medical Journal
