乙肝背景下不典型小肝细胞癌的MRI影像学特点  

MRI imaging features of atypical small hepatocellular carcinoma in the backgroud of hepatitis B

作　　者：刘明明 顾世民 孙妤[1] 邢红岩[1] 王春雨 董红焕 温家兴 LIU Mingming;GU Shimin;SUN Yu;XING Hongyan;WANG Chunyu;DONG Honghuan;WEN Jiaxing(Physical Eramination Center,Cangzhou Central Hospital,Cangzhou,Hebei Province 061001,China;Department of Neurology,Cangzhou Central Hospital,Cangzhou,Hebei Province 061001,China;MRI Room,Cangzhou Central Hospital,Cangzhou,Hebei Province 061001,China)

机构地区：[1]沧州市中心医院体检中心,河北沧州061001 [2]沧州市中心医院神经内科,河北沧州061001 [3]沧州市中心医院磁共振室,河北沧州061001

出　　处：《实用放射学杂志》2022年第11期1807-1810,共4页Journal of Practical Radiology

基　　金：沧州市科技计划自筹经费项目(204106080).

摘　　要：目的分析乙肝背景下不典型小肝细胞癌(SHCC)在MRI各序列上的不典型影像特点.方法回顾性分析经病理证实的39例不典型SHCC患者的MRI资料.结果39例共检出39个病灶,均有乙肝病史,其中37例肝硬化,2例非肝硬化,含脂结节9个.平扫:T_(1)WI显示高信号11个,等信号7个;T_(2)WI显示等或低信号6个;扩散加权成像(DWI)(b=800s/mm^(2))呈等或低信号13个;动态强化:(1)环状强化9个;(2)不规则斑片状或附壁结节强化、门脉期或延迟期廓清10个;(3)不规则斑片状或结中结强化并进行性强化8个;(4)动脉期无强化,门脉期及延迟期轻度强化但低于周围肝实质8个;(5)迟发性中央斑片状强化4个.结论少部分SHCC在MRI不典型T_(1)WI低、T_(2)WI高、DWI高信号,或者增强无典型的“快进快出”征象,综合乙肝背景下SHCC在MRI T_(1)WI、T_(2)WI、DWI序列以及增强的不典型征象进行分析,可提高不典型SHCC的诊断准确性.Objective To analyze the atypical imaging features of small hepatocellular carcinoma(SHCC)in MRI sequence under hepatitis B background.Methods The MRI data of 39 patients with atypical SHCC confirmed by pathology were analyzed retrospec-tively.Results A total of 39 lesions were detected in 39 cases,all of which had history of hepatitis B,including 37 cases of liver eir-rhosis,2 cases of non-liver cirrhosis,9 fatty nodules.Plain scan:11 high signal and 7 equal signal showed on T_(1)WI,6 equal or low signal on T_(2)WI and 13 equal or low signal on diffusion weighted imaging(DWI)(b=800 s/mm^(2)).Dynamic enhancement:(1)ring enhancement in 9 cases;(2)enhancement of irregular patchy or mural nodules,clearance of portal phase or delayed phase in 10 cases;(3)enhancement of irregular patchy or nodal nodules and progressive enhancement in 8 cases;(4)no enhancement in arterial phase,portal phase and delayed phase were slightly enhanced but lower than surrounding liver parenchyma in 8 cases;(5)delayed central patchy enhancement in 4 cases.Conclusion A small part of SHCC do not show typical T_(1)WI low signal,T_(2)WI high signal,DWI high signal in MRI,or enhanced does not show the typical"fast forward and wash out"performance.Comprehensive analysis of the atypical signs of SHCC in MRI T_(1)WI,T_(2)WI,DWI sequence and enhanced under the background of hepatitis B can further improve the diagnostic accuracy of atypical SHCC.

关 键 词：乙肝背景 小肝细胞癌 磁共振成像 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学] R445.2