肝硬化结节与小肝癌的CT、MRI诊断

Diagnosis of cirrhotic nodular and small hepatocellular carcinoma: CT and MRI

在肝硬化结节及小肝癌的早期诊断方面,CT、MRI仍是目前临床工作中最重要的方法,本文阐述肝硬化结节演变为肝癌过程中的几个重要环节的CT、MRI表现及国内、外对此的研究现状,这几个环节包括肝硬化再生结节、发育不良性结节(低、中、高级)、小肝癌及肝癌,它们在CT、MRI表现上各有特征,但相互间也有影像学表现上的重叠,故多数较典型者可以通过CT密度值、MRI信号值及增强表现判断其性质,少部分诊断有困难的病灶可以通过双动脉期扫描、MR菲立磁增强及灌注成像等方法提供更多的诊断信息。

Computed tomography and MRI are the most important modalities by far to early diagnose cirrhotic nodular and small hepatocellular carcinoma （HCC）. This article demonstrated the CT and MR character of several important evolved steps from cirrhotic regenerative nodule （RN） to HCC, which including RN, dysplastic nodule （DN）, small HCC and HCC, and explain state-of-the-art on this research field. These nodules had their own characterized appearances on CT and MRI scans, but overlapping appearances can also be found. That is to say, most of typical nodules can be diagnosed by CT attenuation, MR signal intense and enhancement pattern, part of difficult-diagnosed nodules should be provided much more diagnosis information from other imaging modalities, such as double hepatic artery phase CT scan, SPIO-enhanced MR imaging and hepatic peffusion imaging.