微小肝癌的MRI表现及诊断  

1.5/3.0 T MR Findings and Diagnosis of Micro-small Hepatocellular Carcinomas

作　　者：张见增[1] 胡海东[1] 尤金涛 李勇武[1] 董景辉[1] 安维民[1] 

机构地区：[1]解放军302医院放射科,北京100039

出　　处：《临床放射学杂志》2017年第11期1657-1661,共5页Journal of Clinical Radiology

摘　　要：目的回顾分析微小肝癌的1.5/3.0 T MRI表现,初步提出微小肝癌MRI诊断条件,以提高对微小肝癌的认识和早期诊断率。方法搜集肝癌治疗后复发及慢性肝病背景定期复查发现、经病理及临床诊断的微小肝癌患者共100例(112个癌灶),分析比较其MRI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91%(106/112);T_2WI高信号占83%(93/112);动态增强"快进快出"病灶数占63.3%(76/112),"快进慢出"病灶数占36.7%(36/112)。所有病例2个月~2.5年内复查增大。结论高场MR可作为目前微小肝癌最好的检查方法,建议诊断必需条件:(1)慢性肝病背景;(2)DWI/T_2WI至少一个序列显示高信号;(3)动态增强呈快进快出或快进慢出;(4)一定时期复查病灶进行性增大。Objective Retrospectively analyzing the 1. 5/3. 0 T MR findings of micro-small hepatocellular carcinomas（MHCC） and tentatively presenting the MR diagnostic criteria of MHCC so as to improve the understanding and early diagnostic rate of MHCC. Methods 100 cases MHCC（112 foci） of pathologically and clinically diagnosed HCC in patients post-treatment or chronic hepatopathy patients were gathered. The findings of plain and dynamic contrast-enhancement（DCE） MR scan were analyzed and the changes in the reexaminations were compared. Results The main MR findings were as follows： The rate of neoplastic foci with high signal in DWI was 91%（106/112）. The rate of neoplastic foci with high signal in T_2WI was 83%（93/112）. In DCE,the rate of neoplastic foci with ＂arterial hypervascularity and venous or delayed phase washout＂was 63. 3%（76/112）,and the other which had ＂arterial hypervascularity and venous or delayed phase late washout＂was 36. 7%（36/112）. All neoplastic foci gradually enlarged in 2 months to 2. 5 years reexamination.Conclusion At present,1. 5/3. 0 T MR might be served as the best method for detecting MHCC. The indispensible diagnostic criteria were suggested like these：（1） Background Chronic hepatopathy;（2） Showing high signal in at least one series of DWI and T_2WI;（3） In DCE series,showing ＂arterial hypervascularity and venous or delayed phase washout ＂or＂arterial hypervascularity and venous or delayed phase late washout＂;（4） Gradually increase in size in certain period reexamination.

关 键 词：肝疾病 肝细胞肝癌 磁共振成像 

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]