动态增强MRI肝脏假肿瘤性病变和高血供型肝癌的研究

Dynamic contrast enhanced MR Imaging of hepatic pseudotumorous lesions and hypervascular hepatocellular carcinoma

目的探讨动态增强磁共振上高血供型肝癌和假肿瘤性病变的信号特点。方法回顾性分析平扫和动态增强图像上病灶的大小、形态、位置和信号变化。结果将临床资料分为2组,高血供肝癌组病灶32个,假肿瘤性病灶28个。肝癌组24个病灶为结节形,8个为不规则形,T1WI为低信号,T2WI为高信号,平衡相为低信号病灶17个,明显高于假肿瘤性病变(P<0.05);假肿瘤性病变组14个病灶为楔形,8个为结节状,6个为不规则形。16个病灶位于肝脏包膜下,7个位于距包膜3cm内,5个病灶位于肝脏中心部位,假肿瘤性病变位于包膜下比例明显高于肝癌(P<0.05)。T1WI上,20个假肿瘤性病灶为等信号,T2WI上,26个病灶为等信号,平衡相上12个病灶为高信号,16个为等信号。随访过程中,11个假肿瘤性病灶大小无变化,6个病灶缩小,11个病灶消失。结论根据病灶的信号特点、位置形态和随访变化,有助于对高血供型肝癌和假肿瘤性病变进行鉴别。

Objective To study characteristics of hypervascular hepatocellular carcinoroma and hepatic pseudotumorous lesions on dynamic contrast enhanced MRI, Methods Imaging data were divided into two groups as hypervascular hepatocellular carcinoma group （32 cases） and hepatic pseudotulnorous group （28 cases）. Size, shape, location and intensity of all cases were analyzed retrospectively with respect to plain scanning and dynamic contras＇t enhanced MRI. Results Hypervasctliar hepatocellular carcinoma group （n 32） included 24 nodular lesions and 8 irregularly outlined, presenting hypointensity on T1WI and hyperintensily, on T2WI. 17 cases showed hypo-irttensity, significantly higher than that ofpseudottanorous group（P 〈 0.05 ）. Hepatic pseud.otttmorous group （n - 28） included 14 wedge-shaped lesions, 8 nodular and 6 irregularly outlined, 16 cases were subcapsular, 7 were within 3cm away from the capsule, and 5 were in the center of the liver. Hepatic pseudotumorous group had more lesions subcapsular than the carcinoma group（P 〈 0.05）. 20 pseudotumorous lesions were iso-intansity on T1WI, 26 lesions were iso-intensity on T2WI. 12 lesions were hyper-intensity and 16 were iso-int ensity Oil equilibritun-phasc. Durirtg follow up, 11 pseudotumorous lesions did not change sizes. 6 lesions shrank and 11 lesions disappeared. Conclusion The shape, location and intensity of lesions are helpful for bringing out differences between hypervascular hepetocellular carcinoma and pseudotumorous lesions,