肝胆特异性磁共振对比剂Gd-EOB-DTPA在肝脏局灶性结节增生的诊断价值  

The Value of Hepatic-biliary Specific MR Contrast Agent(Gd-EOB-DTPA) in the Diagnosis of Focal Nodular Hyperplasia

作　　者：陈勇 张颖[2] CHEN Yong ZHANG Ying(Department of Radiology, Zhengzhou People＇s Hospital Department of Radiology, Anyang People＇s Hospital)

机构地区：[1]郑州市人民医院影像科 [2]安阳市人民医院影像科

出　　处：《中国医学计算机成像杂志》2017年第5期422-426,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨使用Gd-EOB-DTPA增强MRI在肝脏局灶性结节增生(FNH)的诊断价值。方法:进行回顾性分析16例经病理证实的FNH的MRI检查资料,所有病例均行MRI平扫及Gd-EOB-DTPA增强扫描。结果:16例共20个病灶,位于肝左叶8个,肝右叶6个,尾状叶2个,跨叶生长4个。MRI特征T1WI 9例呈等信号,7例呈稍低信号,抑脂T2WI 6例呈等信号,10例呈稍高信号;7例病灶见中央瘢痕,呈T1WI低信号,T2WI高信号。动态增强动脉期16例病灶均明显强化;门脉期持续强化,12例呈稍高信号,4例呈等信号;平衡期11例呈等信号,5例呈稍高信号;肝细胞特异期,7例病灶以等信号为主,9例呈不均匀稍高及等、低混杂信号。中央瘢痕动脉期无强化,门脉期及平衡期持续延迟强化,肝细胞特异期呈低信号。结论:使用Gd-EOB-DTPA增强MRI诊断FNH具有很高的敏感性及特异性,FNH对Gd-EOB-DTPA特异性摄取而呈等、高信号,Gd-EOB-DTPA增强能准确地显示FNH的血供特点及病理特征,大大提高与肝内其他病变的鉴别诊断能力。Purpose： To investigate the value of hepatic-biliary specific MR contrast agent （Gd-EOB-DTPA） in the diagnosis of focal nodular hyperplasia （FNH）. Methods： MRI findings of 16 cases with FNH proved by pathology results were analyzed retrospectively. All the patients were performed MRI plain and enhanced scan with Gd-EOB-DTPA. Results： There were 16 cases with totally 20 lesions, 8 lesions of them were located at left lobe, 6 at right lobe, 2 at caudate lobe, 4 were crossed the lobes. MRI findings： 9 cases showed equal intensity signals, 7 cases showed slightly lower intensity signal on T1WI, 6 cases showed equal intensity signals, 10 cases showed slightly higher intensity signal on fat suppression T2WI. Seven cases were with central scars, and they showed low intensity signal on TIWI, high intensity signal on T2WI.Sixteen cases were significantly enhanced during the arterial phase; and they were enhanced continuously during the portal phase, and 12 cases of them showed slightly higher intensity signal, 4 cases showed equal intensity signal; during the balance phase, 11 cases showed equal intensity signal, 5 cases showed slightly higher intensity signal; during the liver cell specific phase, 7 cases showed equal intensity signals, 9 cases were with uneven mixed-intensity signals. Central scars were not enhanced during the arterial phase, they were enhanced during portal venous phase and balance phase, and showed low intensity signal during liver cells specific phase. Conclusion： Gd-EOB-DTPA-enhanced MRI could be used to accurately show the blood supply and pathological features of FNH, and greatly improve the ability of differential diagnosis with other hepatic diseases.

关 键 词：钆塞酸二钠 肝脏局灶性结节增生 磁共振成像 对比剂 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.4[医药卫生—诊断学]