原发性肝细胞癌磁共振成像与血管造影检查的对照研究

The Comparative Study of MRI and Hepatic Angiography in Hepatocellular Carcinoma

目的：探讨原发性肝细胞癌（HCC）的MRI与肝血管造影表现的相关性。材料与方法：研究对象：于MRI检查后10日内行肝血管造影检查的HCC患者66例。MRI采用SE序列，矩阵128×256，层厚5～10mm，层间隔1mm。T1加权像：TR＝530cm，TE＝15ms，T2加权像：TR＝2000ms，TE＝80ms。肝血管造影采用Seldinger经皮穿刺股动脉插管技术，行肝动脉和间接门静脉造影。结果：（1）MRI信号强度改变（T1、T2）：极低、极高；等、等；低、高；低、极高。内部信号多为不均匀。（2）肝血管造影显示肿瘤血供分为多血供和少血供。肿瘤染色表现为均匀染色、不均匀染色和轻微染色（3）门静脉内瘤栓：MRI和肝血管造影显示率无显著差别。（4）肝血管造影显示肝动脉与静脉分流的病例在MRI上表现为病灶边缘部分或全部模糊不清；病灶一侧轮廓不规则；肝段或肝叶信号强度改变病灶边缘流空血管增粗、增多。结论：HCC的MR成像与肝血管造影表现有相关性。

Objective: To study the correlation between MRI findings and hepatic angiography (HAG) findings of hepatocellular carcinoma(HCC). Materials and Methods: Sixty-six patients with HCC underwent HAG and subsequent MRI in 10 days. With a section thickness of 5 ～10mm, interval gap of 1mm and 128 x 256 matrix, spin-echo sequences were used. T1WI was obtained with TR 53Oms and TE 15ms; T2WI with TR2000ms and TE 80Tms. HAG, including indirect portography was performed with Seldinger technique. Results: (1 ) MRI sigal intensity on T1 and T2were as follws: ultra-hypo and ultra-hyper (n = 4), iso-intensity and iso-intensity (n = 6), hypo and hyPer (n = 43 ), hypo and ultra-hyper (n =13), respectively. The intemal architectures were heterogeneous in most cases. (2) HAG demonstrated 41 hyper-vascular tumors and 25 hypo-vas-cular tumors. Tumor stain was homogeneous in 29, inhomogeneous in 12, slightly stained in 25 cases. (3) Portal thrombosis was revealed in 14 ca-ses on MRI, and 15 cases on HAG. (4) Arteriovenous shunt was found in 27 cases with MRI and 29 cases with HAG. Conclusion: MRI is a safeand accurate mean for the diagnosis of HCC, and it provides the information well correlated with that by HAG.