3.0 T磁共振对肝硬化背景上小肝癌检出的价值  

Evaluation of 3. 0 T Magnetic Resonance Imaging in Detecting Small Hepatocellular Carcinoma upon Cirrhosis Background

作　　者：张小彪[1] 马菁[1] 郭玉林[1] 李婷[1] 何花[1] 蔡磊[1] 侯登华[1] 

机构地区：[1]宁夏医科大学总医院放射科,银川750004

出　　处：《临床放射学杂志》2014年第8期1193-1197,共5页Journal of Clinical Radiology

基　　金：宁夏回族自治区教育厅资助项目(编号:NGY2012051);宁夏医科大学"博士学位建设学科"开放课题(面上项目)

摘　　要：目的探讨3.0 T MRI对肝硬化背景上小肝癌检出的价值,提高MRI对肝硬化背景上小肝癌的早期检出率。方法回顾性分析87例肝硬化背景上小肝癌患者MRI资料,均行常规自旋回波序列(T1WI同、反相位,T2WI)、LAVA序列多期增强扫描及DWI,分析比较各序列对小肝癌的检出率。结果 87例小肝癌,共发现98个病灶。(1)LAVA增强较DWI检出率高,但两者比较差异无统计学意义(P=0.248);LAVA增强、DWI对小肝癌检出率分别与T1WI、T2WI比较差异有统计学意义(P值分别为0.000、0.003;0.000、0.048)。(2)T1WI、T2WI、DWI、LAVA增强对直径>1 cm小肝癌病灶总体检出率比较差异无统计学意义(P=0.082),对直径≤1 cm小肝癌病灶检出率除LAVA增强与DWI比较差异无统计学意义(P=0.552)外,LAVA增强和DWI分别与T1WI、T2WI比较,T2WI与T1WI比较差异有统计学意义(P值分别为0.000、0.011;0.000、0.036;0.028)。(3)LAVA动脉期检出小肝癌较门静脉期、平衡期高,且差异具有统计学意义(P值分别为0.002、0.001)。结论 LAVA增强、DWI较T2WI、T1WI能更好地检出肝硬化背景上小肝癌;LAVA增强、DWI对于直径≤1 cm小肝癌检出率明显优于T2WI、T1WI。LAVA动脉期较门静脉期及平衡期有利于对肝硬化背景上的小肝癌的检出。Objective To evaluate 3.0T MRI in detecting small hepatocellular carcinoma （ SHCC ） upon cirrhosis background in order to improve early detection rate of SHCC. Methods A total of 87 SHCC patients with cirrhosis were enrolled in this study. MRI scanning with conventional spin-echo sequence （TIWI with anti-phase, T2WI）, LAVA sequence enhanced multi-phase scanning and DWI were performed in all patients. The SHCC detection rate of each scanning sequence was determined and the MRI findings were retrospective analyzed. Results A total of 98 lesions were detected in 87 patients. （ 1 ） The detection rate by LAVA enhanced scanning was higher than that by DWI although the difference between the two was not statistically significant （P = 0.248 ）. Statistically significant difference in SHCC detection rate exis- ted between LAVA enhanced scanning, DWI and T1WI, T2WI（ P value was O. 000,0.003 ;0.000,0.048 ）. （ 2 ） For 〉 1 cm SHCC, the differences in total detection rate between each other of T, WI, T2 WI, DWI and LAVA enhanced scanning sequences were not statistically significant（P =0.082）, while for ≤1 cm SHCC, statistically significant differences in total detection rate existed between each other among the above mentioned sequences except between DWI and LAVA enhanced scanning（P = 0. 552）, LAVA enhanced and DWI compared with Tl WI,T2WI, T2WI compared with TIWI （P value was 0. 000,0. O11 ;0. 000,0. 036 ;0. 028, respectively）. （ 3 ） For LAVA sequence, the SHCC detection rate in arterial phase was higher than that in portal phase as well as in equilibrium phase, and the difference was statistically significant（P value was O. 002.0. 001 ）. Conclusion Compared with T2WI and T1WI, LAVA enhanced scanning and DWI can more effectively detect SHCC on cirrhosis background. LAVA enhanced scanning and DWI scanning are superior to T2WI and T1WI in displaying ≤ 1 cm SHCC. In detecting SHCC on cirrhosis background with LAVA, arterial phase is better than portal venous ohase and equilibrium

关 键 词：肝硬化 小肝癌 磁共振成像 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤]