肝细胞癌综合治疗后复发的小肝癌患者MRI平扫和动态增强各序列图像表现分析  

The analysis of MRI scan and dynamic contrast-enhancement sequence images features of recurrent small hepatocellular carcinoma patients after combined therapy for hepatocellular carcinoma

作　　者：张志平[1] 陈飞[1] 戴真煜[1] 姚立正[1] 董从松[1] 刘洋[1] 潘文艳[1] ZHANG Zhiping;CHEN Fei;DAI Zhenyu;YAO Lizheng;DONG Congsong;LIU Yang;PAN Wenyan(Department of Radiology,Affiliated Yancheng Hospital of Southeast University Medical College,Yancheng 224001,P.R.China)

机构地区：[1]东南大学医学院附属盐城市第三人民医院影像科,江苏盐城224001

出　　处：《医学影像学杂志》2018年第11期1868-1871,共4页Journal of Medical Imaging

摘　　要：目的分析肝细胞癌(HCC)综合治疗后复发的小肝癌(s HCC)患者磁共振(MRI)图像表现,提高对复发s HCC的认识。方法回顾分析本院36例HCC综合治疗后复发的s HCC患者,共44个病灶,均行MRI平扫和动态增强扫描,其中16例患者在3～6月后复查MRI,分析病灶图像特征。测量典型"快进快出"强化方式癌灶(A组)与非典型强化方式癌灶(B组)的长径和表观弥散系数(ADC)值,并比较两组差异。结果 MRI平扫T2压脂序列显示高信号癌灶39个(88. 64%),T1压脂序列显示低信号癌灶37个(84. 09%),弥散加权成像显示高信号癌灶41个(93. 18%),双回波序列显示含脂质成分癌灶4个(9. 09%)。MRI动态增强序列显示典型"快进快出"强化方式癌灶30个(68. 18%),非典型强化方式癌灶14个(31. 82%),延迟期出现"假包膜"征象癌灶12个(27. 27%)。A组癌灶长径大于B组,ADC值低于B组(P均<0. 05)。结论结合MRI平扫和动态增强各序列,有利于s HCC癌灶的检出,是诊断HCC综合治疗后复发的s HCC的重要方法。Objective To analyze the image features of magnetic resonance （MRI） in recurrent small hepatocellular carcinoma （sHCC） patients after combined therapy for hepatocellular carcinoma （HCC）, and to raise the knowledge of recurrent sHCC for radiologists.Methods A retrospective analysis of 36 cases （44 lesions） of recurrent sHCC after combined treatment was performed. Plain scan and dynamic contrast-enhancement of MR were performed to analyze the image features, 16 cases of them re-performed the MR after 3-6 months. The long diameter and apparent diffusion coefficient （ADC） values of typical ＂fast in and fast out＂ enhancement carcinoma （group A） and atypical enhancement carcinoma （group B） were measured and compared between the two groups.Results MR T 2 weighted imaging with lipid inhibition showed 39（88.64%） high signal lesions, T 1 weighted imaging with lipid inhibition showed 37（84.09%） low signal lesion, diffusion weighted imaging showed 41（93.18%） high signal lesions, dual echo sequence showed 4（9.09%） lesions containing lipid composition. MR dynamic-enhancement sequence showed 30（68.18%） typical ＂fast in and fast out＂ enhancement lesions, 14（31.82%） atypical enhancement lesions, 12（27.27%） lesion with ＂pseudocapsule＂ in delayed phase enhancement. The carcinoma long diameter of group A was bigger than that of group B, and ADC value was lower than that of group B （all P 〈0.05）.Conclusion Combined MR plain scan and dynamic contrast-enhancement scan, it is conducive to the detection of sHCC and is an important method to diagnose the recurrence of sHCC after HCC comprehensive treatment.

关 键 词：肝细胞癌 小肝癌 磁共振成像 动态增强扫描 表观弥散系数 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]