磁共振成像技术在肝细胞肝癌的研究进展

Research progress of magnetic resonance imaging in hepatocellular carcinoma

肝细胞肝癌(HCC)是肝脏最常见的恶性肿瘤。早期HCC合理治疗可明显提高患者的生存率。弥散加权成像,扩散峰度成像,体素内不相干运动,磁共振波谱成像,动态对比增强成像等功能成像通过多个参数对病变的早期检出,性质判断,恶性程度分级及对不同治疗方案疗效能够准确地评估。超快速并行采集技术(CAIPIRINHA)、水脂分离压脂技术(Dixon)及时间分辨交叉随机轨迹成像(TWIST)3种技术的容积插入法屏气扫描检查(VIBE),即CDT-VIBE序列在短时间内可获得多组动脉期图像,发现其他检查无法发现的一过性强化小病灶,并显示病灶起始强化差异,对提示病灶血供特点有重要意义。此外,磁共振成像可预测HCC的微血管侵犯,即间接预测HCC术后或肝移植术后病变的复发率及总生存时间。

Hepatocellular carcinoma (HCC) is the most common malignant tumors of liver. Rational treatment in early stage of HCC can significantly increase the survival rate of patients. Detection of early-stage liver lesions through diffusion-weighted imaging, diffusion kurtosis imaging, incoherent motion within voxels, magnetic resonance spectroscopy imaging, dynamic contrast-enhanced imaging, or other functional imaging can accurately evaluate grade of malignancy and guide towards the curative effect of different treatment schemes. Volumetric interpolated breath-hold examination (VIBE) with three techniques, namely, CAIPIRINHA, Dixon, and TWIST, i.e., CDT-VIBE sequence can provide multiple sets of arterial phase images in a short time, and detect small foci transient enhancement that cannot be detected by other examinations, and the differences in initial enhancement phase of apparent lesions are of great significance for suggesting hemodynamic characteristics. In addition, magnetic resonance imaging predicts microvascular invasion of HCC, i.e., indirectly predicts HCC lesions recurrence rate, and overall survival time after liver transplantation. This article reviews the current research progress of magnetic resonance imaging technology in HCC.