肝脏局灶性病变MR动态增强扫描的临床应用

Clinical application of dynamic contrast-enhanced MRI scanning focal liver lesions

目的 :探讨肝脏局灶性病变MR动态增强扫描的方法和临床应用。方法 :回顾性分析68例肝脏局灶性病变 :包括原发性肝细胞癌24例 ,周围型胆管细胞癌2例 ,转移瘤16例 ,海绵状血管瘤24例 ,局灶性结节增生2例。MR动态增强扫描采用一次屏气梯度回波序列 ,快速小角度激发二维(FLASH2D)准T1WI加权像。结果 :MR动态增强扫描显示肝内不同局灶性病变有不同的强化特征。原发性肝细胞癌动脉期明显强化 ,门脉期强化迅速减弱 ;周围型胆管细胞癌呈逐渐缓慢强化 ;转移瘤呈环型强化 ;海绵状血管瘤持续明显强化 ;局灶性结节增生动脉期明显强化 ,门脉期明显或轻度强化 ,延迟期中心疤痕轻度强化。结论

Objective:To study method and clinical application of dynamic contrast-enhanced MR scanning in the diagnosis of focal liver lesions.Methods:Focal liver lesions 68 cases,including hepatocellular carcinoma(HCC),intrahepatic peripheral cholangiocarcinoma,metastasis,hemangioma and focal nodular hyperplasia,were studied.Breath-hold dynamic scans with FLASH 2D T1-weighted imaging were obtained.Results:Various hepatic focal lesions had different enhancement patterns on the dynamic scans:strong enhancement on arterial phase and slight enhancement on portal venous phase in HCCs;slower enhancement in intrahepatic peripheral cholangiocarcinomas;ring enhancement in metastasises;obvious and keeping long time enhancement in hemangiomas;strong enhancement on arterial phase and slight or obvious enhancement on portal venous phase and slightly delayed enhancement of the central scars in focal nodular hyperplasias.Conclusions:Dynamic Gd-DTPA contrast-enhanced imaging is a useful method in diagnosis of focal liver lesion.