肝胆特异期成像在不典型MR表现肝硬化结节的诊断价值  

The Value of Hepatobiliary Specific Phase Imaging in the Diagnosis of Atypical MR Manifestations of the Macronodular Cirrhosis Nodules

作　　者：张文昌[1] 吴小辉[1] 熊晓玲[1] 陈凌微 林璐雄 朱晓艳 Zhang Wenchang;Wu Xiaohui;Xiong Xiaoling;Chen Lingwei;Lin Luxiong;Zhu Xiaoyan(CT/MRI Room,Imaging Department,Second Hospital of Longyan City,Fujian Province,Longyan,Fujian 364000)

机构地区：[1]福建省龙岩市第二医院影像科CT/MRI室,福建龙岩364000

出　　处：《现代医用影像学》2020年第10期1858-1861,共4页Modern Medical Imageology

摘　　要：目的:探讨肝细胞特异性对比剂钆贝葡胺、钆塞酸二钠肝胆特异期成像在不典型MR表现肝硬化结节的诊断价值。方法:选取2013年至2018年在我院行MRI检查且经手术或穿刺活检病理证实的12个肝硬化结节,观察并分析其常规平扫+增强及肝胆特异期MR表现。结果:T1WI表现为低信号5例、略低信号7例, 12例T1WI反相位较同相位未见信号衰减。压脂T2WI表现为稍高信号5例、中等高信号4例、等信号3例。DWI表现为等信号7例、不均匀等至稍高信号3例、稍高信号2例,平均ADC值1.42x10^-3mm^2/s。动态增强扫描9例表现为动脉期未见明确强化或轻度强化、门脉期及延时期持续强化,3例表现为动脉期中度强化、门脉期及平衡期逐渐退出。肝胆特异期7例表现为与周围肝实质等信号、3例信号略高于周围肝实质、2例信号略低于周围肝实质。结论:肝硬化结节常规平扫+增强不典型MR表现复杂多样,与原发性肝细胞癌表现相似,二者具重叠MR影像表现,肝细胞特异性对比剂肝胆特异期扫描病灶与周围肝实质呈等信号或稍高信号,与原发性肝细胞癌肝胆期表现为低信号不同,对不典型MR表现肝硬化结节具有重要诊断价值。Objective:To investigate the diagnostic value of the application of gadobenate dimeglumine(Gd-BOPTA) and gadolinium-ethoxibenzyl-diethylenetriamine pentaacetic acid( Gd-EOB-DTPA) hepatobiliary specific phase imaging in conventional MR plain scan + enhancement of the atypical macronodular cirrhosis nodules.Methods:Twelve patients with the macronodular cirrhosis nodules confirmed by operation or puncture biopsy and MR examination in our hospital from October 2013 to October 2018 were selected to observe and analyze the manifestations of conventional plain scan,dynamic contrast-enhanced scan and hepatobiliary specific phase imaging.Results:5 lesions showed low signal intensity and 7 lesions showed slightly low signal intensity on T1 WI, and no signal attenuation was observed in 12 lesions in the antiphase of T1 WI compared with the same phase. 5 lesions showed slightly high signal intensity、4 lesions showed medium high signal intensity and 3 lesions showed equal signal intensity on Lipid-pressed T2 WI. 7 lesions showed equal signal intensity、3 lesions showed heterogenous equal to slightly higher signal intensity and 2 lesions showed slightly high signal intensity on DWI,with an average ADC value of 1.42 x10^-3mm^2/s. Dynamic contrast-enhanced scan showed no definite enhancement or mild enhancement during arterial phase in 9 lesions, and it was filled during portal venous phase and equilibrium phase, 3 lesions showed moderate enhancement during arterial phase, and gradual withdrawal during portal venous phase and equilibrium phase. The hepatobiliary specific phase in 7 lesions was characterized by the signal of surrounding liver parenchyma, 3 lesions showed slightly higher and 2 lesions showed slightly lower.Conclusion:The macronodular cirrhosis nodules in routine scan + enhanced atypical MR present complex and diverse manifestations, similar to primary hepatocellular carcinoma(HCC), the two overlapping with MR imaging performance.The hepatobiliary specific phase was characterized by equal or slightly higher sign

关 键 词：肝胆特异期 肝硬化结节 不典型MR表现 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]