MR全肝灌注成像在原发性肝细胞癌的初步研究

Preliminary clinical application:whole liver MR perfusion to HCC

目的探讨全肝MR灌注成像(MR perfusion imaging,MRPI)对肝硬化基础上小肝癌的显示和定量评价的价值。方法肝硬化病史、AFP升高、原发性肝细胞癌(hepatocellular carcinoma,HCC)患者7例,经常规MR扫描图像上共发现7个待观察病灶,使用全肝MRPI观察待测病灶的特征。绘制时间-信号强度曲线。观察肿瘤与左、有半肝的肝实质达峰时间(time topeak,TTP)、最大上升斜率(maximum slope of increase,MSI)、最大下降斜率(maximum slope of decrease,MSD)。观察强化曲线的类型。结果 7个病灶均经病理证实为HCC,肿瘤与左、右半肝肝实质的TTP、MSI、MSD分别为(25.536,40.834,44.456)S、(19.0318,11.2481,15.8437)S-1及(14.9591,6.9082,8.9218)S-1,肿瘤与肝实质之间差异有统计学意义(P<0.05)。7个病灶时间-信号强度曲线均表现为早期迅速升高,之后明显下降。结论全肝MRPI有助于肝硬化基础上小肝癌的早期诊断与定量分析。

Objective To study the value of whole - liver MRPI in identification and quantification of malignant nodules in liver cirrhosis. Methods Seven patients （5 males and 2 females） suspected of having HCC owing to AFP increase and a long history of liver cirrhosis were confirmed by dynamic whole - liver 3D imaging. The time - intensity curve was described. The time to peak （TTP）, maximum slope of increase （MSI） , and maximum slope of decrease （MSD） , and the curve types were determined. These meas- urements of the seven suspected nodules, left lobe, and right lobe liver parenchyma were compared respectively by ANOVA and multi- pie comparisons. The results were compared with pathological findings. Results The 7 nodules were diagnosed as HCC by pathology. The difference between TIPs （25. 536, 40. 834, 44. 456） s, MSIs （ 19. 0318, 11. 2481 , 15. 8437） S - 1 and MSDs （ 14. 9591, 6. 9082, 8. 9218） S - 1 of the suspected nodules, left lobe, and right lobe liver parenchyma was statistically significant （P 〈0.05） . Conclusions Whole - liver MRPI can facilitate the deteetion and quantification of HCC nodules with a background of liver cirrhosis.