摘要
AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS:Twenty-two patients with 24 HCC lesionsconfirmed by biopsy or surgical resection underwentMR imaging in 4-9wks after TACE with a superconducting1.5 T MR scanner, including SE T1WI, T2WI and FMPSPGRdynamic contrast scanning. The signal intensities of alllesions on SE T1WI, T2WI and the enhancement patternson FMPSPGR dynamic contrast scanning were observed,and the comparison was made between MRI findingsand pathological results in ail the cases.RESULTS:Of the 24 lesions, the signal intensities werevarious on SE T1WI and T2WI. On T1WI, 13 lesionsappeared as hyperintense, 4 lesions were isointenseand the other 7 lesions were hypointensese.Histologically, hyperintense lesions showed on T1WIwere viable tumor or hemorrhage; isointensities werecoagulative necrosis or inflammatory infiltration;hypointensities were tumor, liquified necrosis,coagulative necrosis or inflammatory infiltration. OnT2WI, 15 lesions appeared as hyperintense, 3 lesionswere isointense and the other 6 lesions werehypointensese. Hyperintense lesions showed on T2WIwere residuals of viable tumor, hemorrhage, liquefiednecrosis or inflammatory infiltration; isointense lesionswere residuals of viable tumor or inflammatoryinfiltration; hypointense lesions were coagulativenecrosis. On FMPSPGR dynamic contrast scanning, 18of the 24 lesions enhanced on early-phase dynamicscanning conesponding to residuals of viable tumor andthe other 6 lesions had no enhancement at this phasebecause complete necrosis were seen in the histologicexamination. On delayed-phase dynamic scanning, 6lesions had permanent enhancement appeared asinhomogeneous hyperintensity and both residuals ofviable tumor and inflammatory infiltration were foundby histologic examination. 18 lesions were hypointenseat this phase and 8 of them coexisted with peripheralring-like enhancement of the lesions resulting fromviable tumors or inflammatory infiltration.CONCLUSION: FMPSPGR MR dynamic contrast scanningcan reflect the pathologic changes of HCC treated byTACE. Especially, early-phase dynamic scanning canevaluate accurately residuals of viable tumor andnecrosis in HCC lesions. FMPSPGR dynamic contrastscanning is useful in the follow-up of patients with HCCtreated by TACE combined with SE T1WI and T2WI, butit is difficult to differentiate peripheral viable tumorsfrom inflammatory infiltration.
AIM:To evaluate the role and limitation of fast multiplanar spoiled gradient-recalled(FMPSPGR)MR dynamic contrast scanning in the follow-up of patients with HCC treated by transarterial chemoembolization CTACE). METHODS:Twenty-two patients with 24 HCC lesions confirmed by biopsy or surgical resection underwent MR imaging in 4-9wks after TACE with a superconducting 1.5 T MR scanner,including SE T_1WI,T_2WI and FMPSPGR dynamic contrast scanning.The signal intensities of all lesions on SE T_1WI,T_2WI and the enhancement patterns on FMPSPGR dynamic contrast scanning were observed, and the comparison was made between MRI findings and pathological results in all the cases. RESULTS:Of the 24 lesions,the signal intensities were various on SE T_1WI and T_2WI.On T_1WT,13 lesions appeared as hyperintense,4 lesions were isointense and the other 7 lesions were hypointensese. Histologically,hyperintense lesions showed on T_1WI were viable tumor or hemorrhage;isointensities were coagulative necrosis or inflammatory infiltration; hypointensities were tumor,liquified necrosis, coagulative necrosis or inflammatory infiltration.On T_2WI,15 lesions appeared as hyperintense,3 lesions were isointense and the other 6 lesions were hypointensese.Hyperintense lesions showed on T_2WI were residuals of viable tumor,hemorrhage,liquefied necrosis or inflammatory infiltration;isointense lesions were residuals of viable tumor or inflammatory infiltration;hypointense lesions were coagulative necrosis.On FMPSPGR dynamic contrast scanning,18 of the 24 lesions enhanced on early-phase dynamic scanning corresponding to residuals of viable tumor and the other 6 lesions had no enhancement at this phase because complete necrosis were seen in the histologic examination.On delayed-phase dynamic scanning,6 lesions had permanent enhancement appeared as inhomogeneous hyperintensity and both residuals of viable tumor and inflammatory infiltration were found by histologic examination.18 lesions were hypointense at this phase and 8 of them coexisted with peripheral ring-like enhancement of the lesions resulting from viable tumors or inflammatory infiltration. CONCLUSION:FMPSPGR MR dynamic contrast scanning can reflect the pathologic changes of HCC treated by TACE.Especially,early-phase dynamic scanning can evaluate accurately residuals of viable tumor and necrosis in HCC lesions.FMPSPGR dynamic contrast scanning is useful in the follow-up of patients with HCC treated by TACE combined with SE T_1WI and T_2WI,but it is difficult to differentiate peripheral viable tumors from inflammatory infiltration.
作者
Fu-Hua Yan Kang-Rong Zhou Jie-Min Cheng Jian-Hua Wang Zhi-Ping Yan Reng-Rong Da Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China Jia Fan Department of Hepatobiliary-surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China Yuan Ji Department of Pathology,Zhongshan Hospital,Fudan University,Shanghai 200032,China
基金
Clinical Important Item of Chinese Health Ministry,No.97030220
