DCE-MRI联合DWI诊断小肝癌的临床价值  

The clinical value of diffusion-weighted imaging in combination with dynamic contrast-enhanced MRI imaging in small hepatocellular carcinoma

作　　者：袁振国[1] 杨金永[1] 赵斌[1] 陈立光[1] 朱向玉[1] 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2012年第10期1696-1698,共3页Journal of Medical Imaging

基　　金：山东省科技发展计划项目(编号:2008GG2004)

摘　　要：目的分析3.0TDCE-MRI联合DWI在小肝癌(SHCC)诊断和鉴别诊断中的价值。方法回顾性分析59例经手术或穿刺活检病理证实的68个SHCC的3.0T MRI容积采集技术(LAVA),多期Gd-DTPA动态增强和弥散(DWI)影像特点。结果 SHCC在Gd-DTPA动态强化及DWI的影像学表现。68个SHCC病灶中,94.1%(64/68)在DWI呈高信号,ADC呈低信号;5.9%(4/68)肝硬化背景明显者呈略高信号,ADC图呈略低信号。平扫T1WI86.8%(59/68)病灶表现为低信号,8.8%(6/68)表现为等信号,4.4%(3/68)表现为高信号。Gd-DTPA动态强化,75%(51/68)病灶动脉期呈高信号、门脉期及平衡期呈低信号,8.8%(6/68)病灶动脉期及门脉期呈高信号、平衡期呈低信号,11.8%(8/68)病灶动脉期强化呈稍高信号、门脉期及平衡期呈等信号,4.4%(3/68)病灶动脉期及门脉期呈无强化等信号、平衡期呈稍低信号。结论小肝癌在DWI(b=500)上表现为高信号,绝大多数小肝癌在MR动态增强图像上表现为动脉期明显强化。因此,联合DWI和DCE-MRI明显有助于提高小肝癌的诊断和鉴别诊断。Objective To analyze the value of DWI and dynamic Gd-DTPA enhanced MRI examinations in the diagnosis and differential diagnosis of small hepatocellular carcinoma （SHCC）. Methods We analyzed the characteristics of 68 small hepatoeellular carcinoma （SHCC on diffusion-weighted imaging （DWI） and dynamic Gd-DTPA enhanced MR1 in 59 patients, retrospectively. Results DWI and Gd-DTPA enhaneed MR images detected 68 SHCCs. Sixty fours SHCCs （94.1%） showed obvious hypermtensity on DWI and 4（5.9%） SHCCs in patients with severe cirrhosis showed mildly hyperintensity. On Gd-DTPA enhanced MR images, 51 （75%） SHCCs were significantly enhanced on arterial phase and showed hypointensity on portal and equilibrium phases, 6 SHCCs（8.8 %） were significantly enhanced on arterial phase and showed hyperintensity on portal and hypointensity on equilibrium phases, 8（11.8%） SHCCs were mildly enhanced on arterial and portal phase and showed isointensity on equilibrium phase. One SHCC showed isointensity on arterial and portal phases and hypointensity on and equilibrium phase,respectively. Conclusion The combination of DWI and Gd-DTPA enhanced MR imaging have very important clinical values in the diagnosis of SHCCS in which most of the SHCCs were greatly enhanced on arterial phase on Gd-DTPA enhanced MR imaging and all SHCCs showed hyperintensity on DWI （b = 500）.

关 键 词：肝脏 小肝癌 磁共振成像 动态增强扫描 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]