摘要
目的:探讨肝退变结节与早期小肝癌的MRI的影像表现及其鉴别诊断。材料与方法:利用高场强磁共振(MRI)1.5T扫描仪对2009.12-2014.12期间随机抽取30例有肝硬化病史患者进行MRI检查,常规行平扫、动态增强及弥散加权成像(DWI)。结果:30例肝硬化患者中出现硬化再生结节者22例(73%),T1WI(同/反相位)上几乎均为等高信号,T2WI序列大多数为低信号,少数为等信号,DWI序列为低信号;其中6例(20%)合并有退变结节,大小4-24mm,T1WI(同/反相位)为高信号,T2WI为低信号,DWI出现相对稍高信号,动态增强动脉期无强化或稍有强化,门脉期和延迟期基本为等或稍低信号;早期小肝癌4例(13%),病灶直径9-30mm,T1WI(同/反相位)为等或稍低信号,T2WI为高信号或部分为稍高信号,DWI为高信号,增强动脉期明显强化而门脉期或延迟期为低信号或等信号;巨块-结节型及多发肝癌者7例(23%),为典型T1WI为低信号,T2WI为稍高信号或高信号,DWI为高信号,增强动脉期明显强化而门脉期或延迟期为低信号。结论:MRI对肝退变结节和早期小肝癌的诊断和鉴别诊断有一定的特征性,其能对肝硬化再生结节、退变结节及早期小肝癌做出一定的影像诊断及评估。
Purpose： Imaging finding and differential diagnosis of hepatic dysplastic nodules and small hepatocellular carcinoma MRI. Method, Using high field magnetic resonance（MRI） 1.5T scanner on 2009. 12 -2014. 12 during the randomly selected 30 patients with cirrhotic patients were examined by MRI, underwent plain scan, dynamic enhanced and diffu- sion weighted imaging（DWI）. Results： 30 cases of liver cirrhosis hardening regenerative nodules in 22 cases （73%） , T1WI （same/anti phase）were nearly as high signal on T2WI sequence, most low signal, the minority is a signal sequence DWI low signal; 6 cases（20% ）had dysplastic nodules, with the size of 4 -24mm, T1WI （same/anti phase）high signal and the low signal in T2WI and DWI appeared relatively slightly high signal, no enhancement in arterial phasedynamic enhanced or slight- ly enhanced, portal venous phase and delayed phase basic equal or slightly low signal; 4 cases of early small hepatocellular carcinoma（ 13% ）, diameter9 -30mm, T1WI（ same/anti phase）equal or slightly low signal on T2WI, high signal or part is slightly high signal on DWI, high signal enhancement, obvious enhancement in arterial phase and portal phase and multiple liver cancer（23% ）, as a typical low signal in T1WI, T2WI is slightly high signal or high signal on DWI, high signal enhancement, obvious enhancement in arterial phase and portal phase low signal. Conclusion： MRI on hepatic dysplastic nod- ules and early small liver cancer have certain features in diagnosis, which can make the imaging diagnosis and evalution of certain of cirrhosis regenerated nodular, earlydysplastic nodules and small hepatocellular carcinoma.
出处
《现代医用影像学》
2015年第6期887-891,共5页
Modern Medical Imageology
关键词
肝硬化
退变结节
癌
MRI
hepatocirrhosis dysplastic nodule cancer Magnetic resonance imsging
