动态增强扫描结合弥散成像对磁共振成像表现不典型肝小血管瘤的诊断价值  

Dynamic MRI and diffusion weighted imaging for small atypical hepatic hemangiomas

作　　者：盛若凡[1] 姚秀忠[1] 饶圣祥[1] 曾蒙苏[1] 

机构地区：[1]复旦大学附属中山医院放射诊断科复旦大学上海医学院影像学系上海市影像医学研究所, 上海200032

出　　处：《中华肝胆外科杂志》2013年第2期88-92,共5页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的分析磁共振成像（MRI）表现不典型的肝小血管瘤（≤2cm）在动态增强及弥散成像中的表现特点，提高诊断的准确性。方法回顾性分析经病理证实的14例患者14个MRI表现不典型的肝脏小血管瘤病灶。分别观测其MRI动态增强扫描、弥散成像表现，比较动态增强各期小血管瘤的对比噪声比，小血管瘤、主动脉、门静脉的信号噪声比，及弥散加权成像中小血管瘤、肝组织的ADC值、病灶-肝组织相对信号比等。进而综合评价此类小血管瘤的MRI表现特点及鉴别诊断要点。结果动态增强中，小血管瘤持续呈相对低信号，以轻度延迟强化为主，其与主动脉、门静脉在动态增强各期信号噪声比变化间存在统计学差异（P〈0．05）。弥散成像中，小血管瘤的信号高于肝组织，其总体上具有较肝组织高的ADC值（P〈0．01）。结论MRI动态增强扫描、弥散成像、ADC值测定等对于肝脏不典型小血管瘤的诊断及鉴别具有重要作用。Objectives To analyse the radiological features of dynamic MRI and diffusion weighted imaging for atypical small hepatic hemangiomas （≤2 cm）. Methods The MR images of 14 patients with 14 pathologically-confirmed small atypical hepatic hemangiomas were retrospectively analyzed. All these patients underwent MR imaging including plain T1 weighted imaging, T2 weighted imaging, dynamic contrast enhanced scanning, and diffusion weighted imaging. The signal-to-noise ra- tios of hemangiomas, the portal vein and the aorta, lesion-to-liver contrast-to-noise ratios, ADCs of hemangiomas and the liver, lesion-to-liver signal ratios in DWI were assessed to generalize the MRI features and the key points in differential diagnosis of this type of hepatic hemangioma. Results In dynamic contrast enhanced scanning, the atypical hemangiomas were barely enhanced and they were hypointense most of the time. The lesions might show a faint enhancement in the delayed phase. There were significant differences in the changes in signal-to-noise ratio between hemangiomas and aorta as well as portal vein in all the three phases （P〈0.05）. In DWI, the signal intensities and ADCs of the hemangiomas were higher than the liver parenchyma （P〈O. 01）. Conclusions MRI dynamic contrast enhanced scanning, diffusion weighted imaging and evaluation of the ADCs were important in the diagnosis and differential diagnosis of small atypical hepatic hemangiomas.

关 键 词：肝脏 血管瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]