肝硬化不典型增生结节的影像学与病理对照研究  

Comparative study of imaging and pathological findings of dysplastic nodule in the background of cirrhosis

作　　者：邢卫红[1] 杨堉杰 侯懿轩 董发发 杨明 李若旭[1] XING Weihong;YANG Yujie;HOU Yixuan(Department of Radiology,Shijiazhuang Fifth Hospital,Hebei,Shijiazhuang 050021,China)

机构地区：[1]河北省石家庄市第五医院放射科,050021

出　　处：《河北医药》2023年第12期1848-1851,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20210170)。

摘　　要：目的分析肝硬化背景下不典型增生结节在1.5T MRI中的影像学表现,并评估其诊断价值。方法回顾性分析2018年1月至2019年1月经1.5T MRI诊断为肝硬化不典型增生结节(dysplastic nodule,DN)的25例患者,共检出28个结节,其中有22例患者为单发结节,3例患者为双发结节。所有结节均经超声引导下穿刺活检并经病理证实。结果25例患者检出的28个结节,其中22例单发病例中,16个为不典型增生结节,6个为不典型增生结节伴局部癌变,3例多发病例中均为不典型增生结节与肝癌结节并存。结论在1.5T MRI上,DN主要表现为T1WI呈高或等信号,T2WI呈高信号,增强扫描后在动脉期、静脉期及延时期以轻度强化为主。当DN结节中出现T2WI及DWI高信号,增强扫描可见“快进快出”时,提示出现结节癌变或部分癌变,临床需结合实际情况采取合适的治疗手段。Objective To analyze the imaging findings of dysplastic nodule(DN)in the background of cirrhosis using 1.5T magnetic resonance imaging(MRI)and to assess their diagnostic value.Methods A total of 25 patients(28 nodules)diagnosed as DN in the background of cirrhosis by 1.5T MRI between January 2018 and January 2019 were retrospectively analyzed.There were 22 cases of single nodules and 3 cases of double nodules.All DNs were pathologically confirmed after ultrasound-guided biopsy.Results A total of 28 DNs in 25 patients were analyzed.Among the 22 cases of single nodule,there were 16 DNs,and 6 DNs combined with local carcinoma.All the 3 cases of double DNs accompanied hepatocellular carcinoma nodes.Conclusion On 1.5T MRI scans,DN is mainly characterized by high or equal signal in T1-weighted imaging(T1WI)and high signal in T2-weighted imaging(T2WI),with mild enhancement in the arterial phase,venous phase and delayed phase after enhancement scan.High signals in T2WI and diffusion-weighted imaging(DWI),or the presence of"fast in and fast out"in the enhancement scan of DN indicate nodal carcinoma or partial carcinoma.Appropriate management should be given based on individualized conditions.

关 键 词：不典型增生结节 HCC 肝硬化 扩散加权成像 

分 类 号：R657.31[医药卫生—外科学]