CT、MRI多期增强扫描对小肝癌的诊断价值  

Value of computed tomography and magnetic resonance imaging in diagnosis and differential diagnosis of small hepatocellular carcinoma

作　　者：马艳[1] 张雪林[1] 李新瑜[1] 张琳[1] 苏欢欢[1] 詹传银[1] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《南方医科大学学报》2008年第12期2235-2238,共4页Journal of Southern Medical University

摘　　要：目的分析小肝癌的CT、MRI表现,提高对小肝癌诊断的正确率。方法回顾性分析经病理及临床随访证实的41例小肝癌患者的平扫及动态增强CT、MRI表现,观察病灶大小、密度或信号强度、强化方式、有无包膜等。结果CT检查28例29个病灶,平扫以低密度为主;MRI检查17例18个病灶(包括4例已做CT检查的病人),平扫T1以低信号为主,T2以高信号为主。动态增强扫描动脉期表现为全瘤性强化CT15例、MRI13例,等密度或等信号CT4、MRI4,延迟扫描为低密度或低信号CT25例、MRI12例;13例在延迟期可见假包膜强化。结论动态增强三期扫描能够显示小肝癌的血供特点,提高小肝癌的检出率及与肝脏其他病变的鉴别能力。Objective To analyze the computed tomography （CT） and magnetic resonance imaging （MRI） findings of small hepatoceUular carcinoma to improve the accuracy in the diagnosis. Method This retrospective analysis involved 41 patients with small hepatocellular carcinoma cases confirmed by pathological examination of the biopsy samples or follow-up. These patients were assessed for CT and MRI findings including lesion size, density or signal intensity, enhancement patterns, and presence of tumor capsules. Results On unenhanced CT images, small hepatocellular carcinomas were displayed mainly as low-density masses, and the majority of tumors presented with low signal intensity on Tl-weighted unenhanced MR images with increased signal intensity on T2-weighted images in comparison with the surrounding liver parenchyma. Most of tumors showed intense enhancement during the arterial phase （CT in 15 cases and MRI in 13 cases）, but some appeared isointense to the liver parenchyma （CT in 4 cases and MRI in 4 cases）. In portal and delayed phases, the tumors typically had lower signal intensity than that of the surrounding liver tissues （CT in 25 cases and MRI in 12 cases） with enhancement of the tumor capsules （13 cases）. Conclusion Dynamic enhanced scanning can be more informative of the pathology and blood supply of small hepatocellular carcinoma. Early and late arterial phase imaging may help in detecting the small lesions and in making differential diagnosis.

关 键 词：小肝癌 计算机X射线断层造影 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤]