超顺磁性氧化铁在肝脏局灶性病变中的定性研究  

Diagnostic Value of Superparamagnetic Iron Oxide for Focal Hepatic Lesions

作　　者：郑蔚巍[1] 周康荣[1] 陈祖望[1] 沈继章[1] 陈财忠[1] 张澍杰[1] 

机构地区：[1]复旦大学医学院附属中山医院放射科,上海200032

出　　处：《临床放射学杂志》2001年第4期246-250,共5页Journal of Clinical Radiology

摘　　要：目的　探讨超顺磁性氧化铁 (SPIO)增强MRI在肝脏局灶性病变的定性能力。材料与方法　 43例怀疑肝占位者经常规MRI和Gd DTPA增强后 1～ 7后 ,行SPIO增强检查。其中 31例经手术病理证实 ,12例经随访、实验室生化检查及临床资料证实。分析平扫MRI及SPIO增强后病灶的信号变化 ,并与Gd DTPA动态增强结果相对照。结果　 43例共 12种病变 ,单发病灶 2 1例 ,多发病灶 2 2例。包括原发性肝细胞肝癌 2 2例 ,血管瘤 5例 ,囊肿 4例 ,转移性肝癌 5例 ,肝硬化结节 4例 ,局灶性结节增生 (FNH) 5例 ,其他病变 6例。 2 2例多发病灶中有 8例合并 1或 2种病变。SPIO增强后 ,肝细胞肝癌T1WI为等或略高信号 ,T2 WI为较高信号 ;血管瘤T1WI为较高信号 ,T2 WI信号同平扫为高信号 ;囊肿T1WI、T2 WI信号无改变 ;肝硬化结节T2 WI为等信号同正常肝实质 ;FNHT2 WI信号明显下降。其余病变的诊断SPIO增强不具有特征性 ,须与Gd DTPA动态增强相结合。结论　SPIO具有一定的定性能力 ,与Gd DTPA增强相结合 ,可帮助提高肝局灶性病变诊断和鉴别诊断的准确性。Objective To evaluate superparamagnetic iron oxide (SPIO) enhanced MRI in the diagnosis of focal hepatic lesions.Materials and Methods This study included 43 cases with suspected focal hepatic lesions. All patients underwent plain and Gd DTPA enhanced MRI, SPIO enhanced MRI was taken 1～7 days later. The diagnosis was pathologically confirmed in 31 cases, while clinically proved in the other 12 cases. The changes in signal intensity (SI) of the lesions before and after SPIO enhancement were analyzed and compared with that of Gd DTPA enhancement.Results Multiple lesions were seen in 22 cases, of which 8 cases were accompanied by one or two diseases. Hepatic lesions included following diseases: primary hepatocellular carcinoma (HCC, n=22), hemangioma (n=5), cyst (n=4), metastases (n=5), cirrhotic nodule (n=4), focal nodular hyperplasia (FNH, n=5), and miscellaneous diseases (n=6). After SPIO enhancement, some lesions showed certain changes in SI. For HCC, the lesions displayed iso or slightly hyperintense on T 1WI and moderate hyperintense on T 2WI. For hemangioma, the lesions showed moderate hyperintense on T 1WI and marked hyperintense on T 2WI similar to that on plain scan. For cyst, no changes in SI were seen on both T 1WI and T 2WI, while cirrhotic nodules demonstrated iso intense on T 2WI same as the normal hepatic parenchyma. The SI of FNH decreased significantly on T 2WI. For the other 6 lesions no specific menifastations were found after SPIO enhancement, and the diagnosis had to be based on the findings with Gd DTPA dynamic enhancement. Conclusion A combination of SPIO enhancement and the Gd DTPA dynamic enhancement can improve the accuracy in diagnosing focal hepatic lesions.

关 键 词：肝局灶性病变 超顺磁性氧化铁 诊断 肝疾病 定性研究 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]