钆塞酸二钠对肝脏局灶性结节增生的诊断价值  

The Diagnostic Value of Gd-EOB-DTPA in the Diagnosis of Focal Nodular Hyperplasia

作　　者：张进跃[1] 王岩[2] ZHANG Jin-yue;WANG Yan(Department of Radiology,the Third People's Hospital of Luohe,Luohe 462000,Henan Province,China)

机构地区：[1]河南省漯河市第三人民医院放射科,河南漯河462000 [2]解放军总医院放射科,北京100853

出　　处：《中国CT和MRI杂志》2018年第2期4-6,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨使用钆塞酸二钠(GdEOB-DTPA)增强MRI在肝脏局灶性结节增生(focal nodular hyperplasia,FNH)的诊断价值。方法进行回顾性分析14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。结果位于肝左叶6例,肝右叶4例,尾状叶2例,跨叶生长2例。MRI特征:T1WI 8例呈等信号,6例呈稍低信号;抑脂T2WI 5例呈等信号,9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14例病灶均明显强化,其中4例病灶周缘见迂曲扩张动脉;门脉期持续强化,12例呈稍高信号,2例呈等信号;平衡期6例呈等信号,8例呈稍高信号;肝细胞特异期,7例病灶以等信号为主,7例呈不均匀稍高及等、低混杂信号。7例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,尤其肝细胞特异期FNH对Gd-EOB-DTPA特异性摄取而呈等、高信号,Gd-EOB-DTPA增强能全面、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。Objective To investigate the value of Gd-EOB-DTPA in the Diagnosis of Focal Nodular Hyperplasia(FNH).Methods MRI findings of 14 cases with FNH proved by pathology were analyzed retrospectively.All were performed MRI plain and enhanced with Gd-EOB-DTPA.Results There were 6 cases located at left lobe,4 cases at right lobe,2 cases at caudate lobe,2 cases crossed leaves.MRI findings:8 cases showed equal signals,6 cases showed slightly lower signal on T1WI,5 cases showed equal signals,9 cases showed slightly higher signal on fat suppression T2WI.7 cases with central scars could be seen,and showed low signal on T1WI,high signal on T2WI.14 cases all were significantly enhanced,including 4 cases were seen tortuosity strengthened arteries during dynamic contrast-enhanced arterial phase,all continued to strengthen during the portal phase,and 12 cases showed slightly higher signal,2 cases showed equal signal;during the balance phase,6 cases showed equal signal,8 cases showed slightly higher signal.During liver cell specific phase,7 cases showed equal signals,7 cases were uneven slightly,equal and slightly lower mixed-signals.7 cases with central scar and without enhancement during the arterial phase,delay continued to enhance during portal venous phase and balance phase,showed low signal during liver cells specific phase.Conclusion The use of Gd-EOBDTPA-enhanced to diagnose FNH had high sensitivity and specificity,especially during liver cell specific phase,FNH specifically absorbed Gd-EOB-DTPA and showed equal、high signal.Gd-EOB-DTPA-enhanced MRI could fully and accurately show the blood supply and pathological features of FNH,and greatly improved 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] R575[医药卫生—诊断学]