MRI多参数成像及动态增强检查对肝细胞肝癌特征性影像表现及鉴别诊断分析  

Analysis of characteristic imaging features and differential diagnostic value of MRI multiparametric imaging and dynamic contrast-enhanced examination for hepatocellular carcinoma

作　　者：金巧薇 卜顺林[1] 吴建伟 JIN Qiaowei;BU Shunlin;WU Jianwei(Department of Radiology,Nanjing Jiangbei Hospital Affiliated to Xinglin Medical College,Nantong University,Nanjing,Jiangsu 210048,China;不详)

机构地区：[1]南通大学杏林医学院附属南京江北医院放射科,江苏南京210048 [2]中国药科大学第一附属南京天印山医院放射科,江苏南京211199

出　　处：《中国临床研究》2025年第2期271-274,共4页Chinese Journal of Clinical Research

基　　金：皖南医学院教学医院科研专项自然科学类项目(WK2024JXYY078)。

摘　　要：目的探讨MRI多参数成像及动态增强对原发性肝细胞肝癌(HCC)的影像诊断及鉴别诊断价值。方法回顾性分析2013年6月至2024年4月在解放军东部战区总医院秦淮医疗区和南京江北医院经病理证实的50例HCC患者的MRI表现,50例均行MRI多参数成像(包括T1WI、T2WI、DWI序列及同反相位成像等)及动态增强检查。结果50例患者中43例(86.0%)有包膜,其中部分包膜不完整,有7例(14.0%)无明确包膜。20例(40.0%)有脂肪变性。部分病灶内伴出血、坏死及囊变。增强显示8例(16.0%)有延迟强化,39例(78.0%)呈“快进快出”强化模式。其中有1例(2.0%)误诊为血管瘤,1例(2.0%)误诊为胆管细胞癌。病理学诊断:43例为中低分化HCC,7例为高分化HCC。结论MRI多序列平扫+动态增强扫描能较好地显示HCC的特征性影像表现及肿瘤内所含的成分特征,对HCC的诊断及其鉴别诊断具有重要价值。Objective To explore the diagnostic and differential diagnostic value of MRI multiparametric imaging and dynamic enhancement in primary hepatocellular carcinoma(HCC).Methods A retrospective analysis was conducted on the MRI manifestations of 50 cases of HCC confirmed by pathology at the General Hospital of the Eastern Theater Command of the PLA Qinhuai Medical District and the Nanjing Jiangbei Hospital from June 2013 to April 2024.All 50 cases underwent MRI multiparametric imaging(including T1WI,T2WI,DWI sequence,and phase contrast imaging)and dynamic contrast-enhanced examination.Results Among the 50 patients,43 cases(86.0%)had capsules,with some incomplete capsules and 7 cases(14.0%)without clear capsules.Twenty cases(40.0%)had fatty degeneration.Some lesions were accompanied by bleeding,necrosis,and cystic changes.Eight cases(16.0%)showed delayed enhancement,and 39 cases(78.0%)showed a“fast in,fast out”enhancement mode.One case(2.0%)was misdiagnosed as hemangioma,and 1 case(2.0%)was misdiagnosed as cholangiocarcinoma.Pathological diagnosis:43 cases were moderately to poorly differentiated HCC,and 7 cases were highly differentiated HCC.Conclusion MRI multiparametric imaging scan+dynamic contrast-enhanced scan can effectively display the characteristic imaging features and the components contained in the tumor of HCC,which has important value for the diagnosis and differential diagnosis of HCC.

关 键 词：肝细胞肝癌 磁共振成像 多参数成像 动态增强 鉴别诊断 

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