MRI在肝癌治疗后复发微小肝癌诊断中的临床价值  

The clinical value of high field MRI in diagnosis of recrudescent MHCC with the treatments for HCC

作　　者：胡海东[1] 张见增[1] 尤金涛 董景辉[1] 安维民[1] 

机构地区：[1]解放军第302医院放射科,北京100039

出　　处：《中国医学装备》2017年第3期65-69,共5页China Medical Equipment

摘　　要：目的:回顾性分析肝癌治疗后复发微小肝癌(MHCC)的MRI表现,提高对MHCC的认识和早期诊断率。方法:搜集整理50例(57癌灶)肝癌治疗后复发经病理或临床诊断的MHCC患者MRI影像资料,分析其MR平扫及动态增强各序列图像表现及复查变化。结果:主要序列表现:DWI高信号病灶数所占比例为93%(53/57);T2WI高信号病灶数所占比例为89.5%(51/57);T1WI低信号病灶数所占比例为89.5%(51/57);双回波含脂质成分病灶数所占比例为8.8%(5/57);动态增强"快进快出"病灶数所占比例为68.4%(39/57),"快进慢出"病灶数所占比例为31.6%(18/57);延迟期有假包膜强化病灶数所占比例为26.3%(15/57)。所有病例2~15个月内复查病灶增大。结论:高场MRI可作为目前MHCC最好的检查方法,在肝癌治疗后复发MHCC的诊断及复查中有重要作用。Objective： To analyze the MRI manifestations of recrudescent micro hepatic cellular carcinomas（MHCC） after the treatment for hepatocellular carcinoma（ HCC） by using retrospective study, and to improve the awareness and the early diagnostic rate of MHCC. Methods： 50 cases recrudescent MHCC（57 neoplastic foci） with pathological or clinical diagnosis were gathered. The manifestations of MRI plain scan and dynamic contrast-enhancement（DCE） were analyzed, and the changes of them in the reexaminations were compared. Results： The main MRI manifestations were as follows： The rate of neoplastic foci with high signal in DWI was 93%（53/57）; the rate of neoplastic foci with high signal in T2WI was 89.5%（51/57）; the rate of neoplastic foci with low signal in T1WI was also 89.5%（51/57）; the rate of neoplastic foci with lipids compositions in double echo detection was 8.8%（5/57）. In DCE, the rate of neoplastic foci with ＂arterial hypervascularity and venous or delayed phase washout＂ was 68.4%（39/57）; and 31.6%（18/57） was with ＂arterial hypervascularity and venous or delayed phase late washout＂. All neoplastic foci of 2 groups were gradually enlarging in 2-15 months reexamination. Conclusions： At present, high field MRI might be served as the best method for detecting MHCC, and plays important role in diagnosis and reexamination of recrudescent MHCC with the treatment for HCC.

关 键 词：肝细胞肝癌 微小肝癌 MRI 复发 肝疾病 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]