微小肝细胞癌(≤1 cm)的Gd-EOB-DTPA增强MRI表现  

Gd-EOB-DTPA Contrast-enhanced MRI Findings of Micro-hepatocellular Carcinoma(≤1 cm)

作　　者：张岚[1] 黎雅琳 韩鼎盛 周彦汝 朱海云 ZHANG Lan;LI Yalin;HAN Dingsheng;ZHOU Yanru;ZHU Haiyun(MRI Department,The First Affliated Hospital,Henan University ofChinese Medicine,Zhengzhou Key Laboratory of Itelligent Analysis andUtilization of Traditional Chinese Medicine Information;Department of Radiology,The 905th Hospital of PLA Navy)

机构地区：[1]河南中医药大学第一附属医院MRI科,中医药信息智能分析与利用郑州市重点实验室 [2]中国人民解放军海军第九○五医院放射诊断科

出　　处：《中国医学计算机成像杂志》2023年第1期39-43,共5页Chinese Computed Medical Imaging

基　　金：医学科学研究基金2022年科研项目(YWJKJJHKYJJ-BXS5-22039)。

摘　　要：目的:探讨直径≤1cm微小肝细胞癌(mHCC)在钆塞酸二钠(Gd-EOB-DTPA)增强MRI的表现.方法:回顾性分析经病理证实45例mHCC的临床和影像资料,采用多个独立样本列表的x2检验比较不同序列对mHCC的检出率.结果:45个病灶中,25个(55.6%)表现为典型的"快进快出"模式,11个(24.4%)无动脉期高强化(APHE),20个(44.4%)无门脉期廓清(WO),仅1个(2.2%)肝胆期(HBP)呈高信号.HBP低信号对mHCC的检出率最高(97.8%),HBP与T1WI、T2WI、APHE+WO任一序列比较,其检出率差异具有统计学意义(Bonferroni校正,P<0.005).DWI联合"APHE+WO"的病灶检出率为82.2%,HBP联合"APHE+WO"检出率为97.8%,HBP联合DWI的检出率为100%.HBP联合DWI的检出率优于DWI联合"APHE+WO"(P=0.010),HBP联合"APHE+WO"的检出率优于DWI联合"APHE+WO"(P=0.035).结论:Gd-EOB-DTPA增强MRI肝胆期对mHCC的检出率非常高,肝胆期低信号联合DWI弥散受限或"快进快出"强化模式有助于肝细胞癌微小病灶的诊断.Purpose:To investigate the features of micro-hepatocellular carcinoma(mHCC)with diameter≤1 cm on gadolinium ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)contrast-enhanced MRI.Methods:The clinical and imaging data of 45 pathologically confirmed mHCC were retrospectively analyzed,and the detection rate of MRI sequences for mHCC was compared by×test.Results:Among 45 lesions,25(55.6%)lesions showed typical enhancement of"wash-in and wash-out",11(24.4%)lesions without arterial phase hyperenhancement(APHE),20(44.4%)lesions without portal phase washout(WO),and only 1(2.2%)lesion showed high signal intensity on hepatobiliary phase(HBP).The detection rate of HBP hypointensity for mHCC was the highest(97.7%),and the detection rate of HBP was significantly higher than T1WI,T2WI or APHE+WO(Bonferroni correction,P<0.005).The detection rate of DWI combined with"APHE+WO"was 82.2%,the detection rate of HBP combined with"APHE+WO"was 97.7%,and the detection rate of HBP combined with DWI was 100%.The detection rate of HBP combined with DWI was better than that of DWI combined with"APHE+WO"(P=0.010),and HBP combined with"APHE+WO"was better than that of DWI combined with"APHE+WO"(P=0.035).Conclusion:The hepatobiliary phase of Gd-EOB-DTPA contrast-enhanced MRI has a very high detection rate for mHCC, and HBP hypointensity combined with DWI restriction or "APHE+WO" is very helpful for the diagnosis ofmicro-lesions ofhepatocellularcarcinoma.

关 键 词：肝细胞癌 钆塞酸二钠 磁共振成像 肝胆期 

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