3.0TMR动态增强扫描及弥散成像联合应用诊断小肝癌的影像价值

The value of 3.0T MR dynamic enhanced MR scan and DWI in the diagnosis of small hepatocelluar carcinoma

目的分析小肝癌(SHCC)动态增强及弥散成像(DWI)(b值为600s/mm2)的信号特点并探讨二者联合应用的诊断价值。方法回顾性分析经病理证实的37例患者总共41个SHCC病灶的T1WI、T2WI、多期动态增强扫描及DWI的信号改变,并探讨T1WI、T2WI及动态增强(A组),T1WI、T2WI及DWI(B组)及这两种方法联合应用(C组)在SHCC的检出与定性诊断方面的价值。结果 SHCC以速升速降型强化方式为主(73.17%),强化峰值主要位于动脉晚期(75.61%);SHCC与周围肝组织的ADC值存在显著性差异;在病灶检出方面A组与C组的差异无统计学意义,而在病灶的定性诊断方面A组与C组的差异有统计学意义。结论肝脏多期动态增强扫描与弥散成像联合应用更有利于SHCC的定性诊断。

Objective To analyze the signal characteristics of small hepatocellular carcinoma （SHCC） on dynamic contrast enhanced and diffusion weighted imaging （DWI） （b value as 600 s/ram2 ） and to explore the diagnostic value of the combined application of both approaches. Methods The signal changes of 37 patients with 41 SHCC lesions in T1WI, T2WI, DWI and dynanmic contrast-enhanced image were retrospectively analysed, and the value of Tl WI, T2WI and dynamic contrast-enhanced （group A）, T1WI, T2WI and DWI （group B） and the combination of these two methods （group C） in SHCC detection and diagnosis were explored. All of the 41 lesions were confirmed by pathology. Results Most of the SHCC lessons （73.17 %） showed ＂fast filling and rapid washout＂. The peak enhancement appeared mainly in the late arterial phase. There was a significant difference between SHCC and normal liver tissue. There was no significant difference between group A and C in respect of detection and there was a significant difference in respect of diagnosis. Conclusion Enhanced multi-phasic scanning in combination with DWI showed more conducive in respect of diagnosing small nodular lesions.