MRI对肝局灶病变的诊断价值

Diagnosis of Focal Hepatic Iesions with MRI

目的：探讨ＭＲＩ对肝局灶病变的诊断价值。材料和方法：对３９例临床证实的肝局灶病变的病例的ＭＲ图像进行回顾性分析，就其信号特点、内部结构、形态及ＣＮＲ值对肝良、恶性病变的鉴别价值进行估价。结果：Ｔ２Ｗ像上，１００％的肝血管瘤和囊肿为明显高信号，而１００％的肝癌和９２％的转移瘤为高信号（Ｐ＜０．０５）；８５％的良性肿瘤内部结构均匀，而恶性肿瘤均匀者仅为３１％（Ｐ＜０．０５）；７５％的血管瘤和１００％的囊肿呈边缘光滑的类圆形病灶，而肝癌则呈不光滑分叶状（６７％）或不规则形（３３％），转移瘤７５％为不规则形，２５％为分叶状，良性肿瘤ＣＮＲ值高于恶性肿瘤。结论：恶性肿瘤多为边界不规则、内部信号不均匀的病灶，而良性肿瘤则为边缘光滑内部信号均匀，尤其在Ｔ２ＷＩ上，良恶性病变的信号强度有明显差别。

Purpose:To evaluate the role of MR imaging in the diagnosis of focal hepatic lesions.Materials and Methods:Conventional SE MR imaging of 39 patients of focal hepatic lesion were retrospectively analyzed.The shape of lesions,internal architecture,CNR value and characteristics of signal intensity were respectively evaluated.Results:On T2WI,all hemangiomas and cysts(100%) were markedly hyperintense,but most of hepatomas(100%) and metastases(92%) were hyperintense (P<005).85% of benign tumors had a homogeneous internal architecture,but only 31% in malignant tumor(P<005).Most of the hemangiomas (75%) and cysts (100%) had smooth margin and round or oval in shape,while the hepatomas had irregular (33%) or lobulated (67%) border.The mean CNR of benign tumors were higher than those of the malignant ones.Conclusion:The conventional SEMR imaging is useful in differential diagnosis of focal hepatic lesions by considerations of the shape,internal architecture and signal intensity of lesions.