小肝癌自然史的磁共振成像研究  

Natural history of small hepatocellular carcinoma: studied by 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：《中华肿瘤杂志》2005年第4期222-225,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金资助项目 (3 9970 72 8)

摘　　要：目的　研究小肝癌的自然史及磁共振成像(MRI)的价值。方法　1 999年至2 0 0 2年间,对1 92例肝硬化患者进行不定期MRI随访检查,以发现小肝癌病灶。观察病灶MRI表现,测量病灶最大直径,计算成瘤发现时间和肿瘤体积倍增时间,并进行统计分析。结果　共发现33例患者5 8个新病灶,其中2 3例31个为肝硬化结节成瘤,3年累计成瘤率1 2 .0 %。成瘤发现时间(386 .9±2 5 6 .4 )d ,病灶最大直径(2 .2 5 8±1 .0 74 )cm ,成瘤发现时间与病灶最大径的立方(D3 )间具有明显相关性(P <0 .0 1 )。肿瘤体积倍增时间2 0～2 79d ,平均1 0 4d。结论　肝硬化患者有较高的成瘤率。定期MRI随访检查有助于早期发现成瘤病灶,随访间隔以3～6个月为宜。Objective To study natural history of small hepatocellular carcinoma(sHCC) and value of MRI in this research. Methods From 1999 to 2002, serial MR imagings were performed in 192 patients with cirrhosis no less than twice in order to detect sHCC focus. Characteristic MRI findings of focus were analysed. Diameters of focus(D) were measured. Tumorigenesis detected time(T) was counted;T and D were analysed by statistics and tumor volume doubling time(T_d) was calculated. Results Fifty-eight new tumor foci in 33 patients were found, including 31 foci in 23 patients developed on the basis of cirrhosis, with a 12.0% cumulative tumorigenic rate of three years. The tumorigenesis detected time(T) was 386.9±256.4 days and the maximum diameter(D) was 2.258±1.074 cm. T was statistical correlated with D3 (P<0.01) and regressive formulas were established: D3=-2.69+0.058T(P=0.0007), D3=-72.13+16.04lnT(P=0.0064). Tumor volume doubling time was 20～279 days (mean:104 days). Conclusion The percentage of tumorigenesis is high in patients with cirrhosis. Regular MRI examinations are necessary to detect sHCC early. The optimal interval time is 3～6 months.

关 键 词：自然史 小肝癌 成像研究 肝硬化患者 倍增时间 肿瘤体积 磁共振成像 2002年 1999年 MRI表现 肝硬化结节 肝癌病灶 统计分析 早期发现 随访检查 大直径 成瘤率 不定期 相关性 最大径 

分 类 号：R735.7[医药卫生—肿瘤]