高分化肝细胞癌的MRI表现  

Magnetic resonance imaging manifestations of welldifferentiated primary hepatocellular carcinoma

作　　者：张少平[1] 郑锦阳[2] 陈向荣[1] 朱聪辉[1] 陈杰云[1] 

机构地区：[1]福建医科大学附属泉州第一医院影像科,福建泉州362000 [2]福建医科大学附属泉州第一医院病理科,福建泉州362000

出　　处：《中国现代医学杂志》2015年第18期21-25,共5页China Journal of Modern Medicine

摘　　要：目的探讨高分化肝细胞癌的MRI表现。方法回顾性分析14例经病理证实的原发性高分化肝细胞癌的MRI表现。结果 16个病灶,分别位于:肝右叶11个,肝左叶5个(外生型病灶1个)。大部分病灶呈类圆形,最大直径约11 cm,最小约0.5 cm,中位值约2.5 cm。平扫:压脂T1WI呈低信号11个,略低信号2个,等信号3个;同反相位信号无明显差异13个,反相位信号部分降低3个;压脂T2WI呈中等高信号11个,稍高信号3个,等信号2个;DWI呈中等程度高信号9个,稍高信号5个,等信号2个。增强扫描:动脉期呈明显强化13个,中度强化2个,轻度强化1个,门脉期及平衡期强化程度均降低,但14个病灶其信号仍高于同期肝实质信号,2个病灶门脉期呈高信号,平衡期呈等信号。12个病灶出现假包膜强化,其中8个病灶包膜完整,4个病灶包膜不完整,包膜平衡期强化明显。4个病灶未见假包膜,病灶直径均<1 cm。结论高分化肝细胞癌的MRI影像表现具有特征性表现,大部分病例可准确诊断。【Objective】 To explore the manifestations of magnetic resonance imaging（MRI） in well-differentiated primary hepatocellular carcinoma（HCC）. 【Methods】The MRI manifestations from 14 cases of pathologically confirmed well-differentiated HCC were retrospectively analyzed.【Results】In the 14 collected cases there were 16 lesions, of which 11 lesions occurred in right lobe and 5 in left lobe of liver（1 case had extrahepatic lesion）. Most of the lesions were roundish. The size of lesions ranged from 0.5 cm to 11 cm in diameter（the median diameter was about 2.5 cm）. On plain MRI, 11 lesions showed low signal, 2 showed slightly low signal and 3 had equal signal intensity on fat suppression T1 WI. In 13 lesions the signal intensity on in- and out-phase was equal, the signal intensity of the rest partly decreased on out-phase. On fat suppression T2 WI, 11 lesions showed moderately high signal, 3showed slightly high signal and 2 showed equal signal intensity. On DWI, 9 lesions showed moderately high signal, 5showed slightly high signal and 2 showed equal signal intensity. After intravenous injection of contrast media, 13 lesions demonstrated high enhancement, 2 showed medium enhancement and 1 showed slight enhancement at arterial phase. The enhancement of all the lesions decreased at venous and balanced phases; however, still 14 lesions showed signal higher than normal hepatic tissue, 2 lesions showed high signal at venous phase and equal signal at balanced phase. Among the 16 lesions, 12 lesions demonstrated enhancement in the pseudo capsules, in which 8 lesions had complete capsules and others has incomplete capsules, the capsules demonstrated high enhancement at balanced phase. There were no pseudo capsules in 4 lesions with the size less than 1 cm in diameter.【Conclusion】MRI manifestations of well-differentiated HCC may show typical features by which most diagnoses can be identified.

关 键 词：肝细胞癌 高分化 MRI 

分 类 号：R730.44[医药卫生—肿瘤]