3D-FS-FLASH序列在肝细胞癌MRI诊断中的应用价值  

Value of 3D-FS-FLASH Sequence in Diagnosis of Hepatocellular Carcinoma in MRI

作　　者：汪剑[1] 陆建平[1] 田建明[1] 王飞[1] 刘崎[1] 王莉[1] 龚建国[1] 金爱国[1] 曾浩[1] 

机构地区：[1]第二军医大学长海医院放射科,上海200433

出　　处：《中国医学影像技术》2003年第6期699-701,共3页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金资助 (39970 72 8)

摘　　要：目的　评价MRI三维 ( 3D)FS FLASH序列诊断肝细胞癌的价值。方法　 2 0名患者 2 8枚病灶运用二维和三维序列行二次动态增强检查。观察各序列对病灶的显示能力 ,测量信号值 ,计算对比噪声比 (CNR)和增强指数 (EI)。并对三维资料运用多种方法重建。结果　 3D FS FLASH动态增强发现病灶 2 8枚 ,优于二维增强的 2 4枚 (P <0 .0 5 )。二维增强动脉期、T2WI和三维增强动脉期CNR高于二维和三维平扫及增强实质期 (P <0 .0 0 1)。三维序列中病灶的EI >二维序列病灶EI>三维序列肝实质EI >二维序列肝实质EI (P <0 .0 0 1)。经重建 ,5枚病灶可显示供血动脉 ,1枚显示引流静脉 ,1例静脉曲张避免了误诊为肿瘤。结论　 3D FS FLASH动态增强扫描不但诊断肝细胞癌优于 2D序列 ,还能提供更多有价值信息。Objective To evaluate the value of three dimensional (3D) FS FLASH sequence in diagnosis of hepatocellular carcinoma (HCC) in MRI. Methods Twenty eight foci of HCC in 20 patients were underwent twice MR examinations in two days. Two dimensional (2D) T1WI, T2WI and 2D Gd DTPA multiphase dynamic enhanced imagings were acquired in the first examination, and three dimensional (3D) T1WI and 3D Gd DTPA multiphase dynamic enhanced imagings were acquired in the second. The appearances of foci in all sequences were compared. Signal intensities of foci, normal hepatic parenchyma and background noise were measured for calculating contrast noise ratio(CNR) and enhancement index(EI). Multiple planar reconstruction(MPR) and maximize intensity projection(MIP) were used to evaluate the 3D images. Results 17, 7, 24, 4 and 28 foci were displayed in T2WI,nonenhanced 2D T1WI,2D enhanced images,nonenhanced 3D T1WI and 3D enhanced images, respectively( P <0.05).CNRs(mean SD) were 3.65±4.85(T2WI), 0.36±2.37(nonenhanced 2D T1WI), 4.55±3.24(2D arterial phase), -0.71±2.53(2D liver parenchyma phase), -0.36±1.18(nonenhanced 3D T1WI), 3.62±3.60(3D arterial phase) and -1.43±2.35(3D liver parenchyma phase), and CNRs of T2WI, 2D arterial phase and 3D arterial phase were higher than those of nonenhanced 2D T1WI, 2D liver parenchyma phase, nonenhanced 3D T1WI and 3D liver parenchyma phase( P <0.001). EI of focus in 3D enhanced imagings was the highest(1.0931±0.5987), focus in 2D enhanced the second(0.5369±0.2938, P <0.001), hepatic parenchyma in 3D enhanced the third (0.3479± 0.4319 , P <0.001) and hepatic parenchyma in 2D enhanced the fourth (0.1724±0.1573, P <0.001).Supplying arteries of 5 foci and draining vein of one focus were displayed by MIP. And by MIP, a variciform vein was avoided from being misdiagnosed as a carcinous focus. Conclusion 3D FS FLASH multiphase dynamic enhanced scanning are not only better than 2D scanning in diagnosis of HCC, but also able to offer much more valuable

关 键 词：病灶 肝细胞癌 FS MRI诊断 动脉期 动态增强 序列 二维 显示能力 CNR 

分 类 号：R735.7[医药卫生—肿瘤] R816[医药卫生—临床医学]