乙肝肝硬化背景小肝癌CT优于MRI的强化表现特点分析

Analysis of CT Enhanced Features of Small Hepatocellular Carcinoma in Patients with Hepatitis B Cirrhosis

目的分析乙肝肝硬化背景小肝癌(SHCC)CT与MRI强化表现特点。方法回顾性分析2013年8月至2015年8月于我院就治的20例(共26个病灶)乙肝肝硬化患者的影像学检查资料。通过比较所有患者影像学资料中增强后CT与MRI各期相对强化率(r ER)、病灶-肝脏对比率(TLCR)及时间-密度/信号强度曲线类型来分析有别于MRI的CT强化表现特点。结果 SHCC患者CT增强动脉期及平衡期r ER(58.14±13.45)%、(71.56±16.78)%均较MRI(68.79±20.19)%、(82.27±14.36)%显著较低(P<0.05)。SHCC患者CT增强各期TLCR动脉期(14.62±13.74)%、门静脉期(-6.85±8.28)%、平衡期(-14.23±9.64)%均较MRI(23.42±12.31)%、(-2.36±6.75)%、(-5.62±11.41)%显著较低(P<0.05)。SHCC病灶CT强化曲线速升速降型65.38%高于MRI34.62%,速升缓降型30.77%低于MRI61.54%,差异有统计学意义(P<0.05)。结论 CT显示SHCC病灶强化曲线主要为速升速降型,即其强化表现为快进快出的特点;且与MRI相比,更有利于显示SHCC强化"退出"的特点。结论 SHCC;CT;强化;

Objective To analyze CT and MRI enhanced features of small hepatocellular carcinoma （SHCC） in patients with hepatitis B cirrhosis. Methods From Aug. 2013 to Aug. 2015, a total of 20 patients （26 focuses） with hepatitis B cirrhosis in our hospital were taken as the clinical research objects. The imaging data including the relative enhancement ratio （rER） of enhanced CT and MRI, the focus liver contrast ratio （TLCR） and the time density / signal intensity curve type of the patients were collected and compared in order to analyze their features of MRI and enhanced CT. Results The rER of CT enhanced arterial phase and equilibrium phase in SHCC patients were respectively （58.14±13.45）%, （71.56±16.78）% which were significantly lower than those of MRI （68.79±20.19）%, （82.27±14.36）%（P〈0.05）. The TLCR of CT enhanced arterial phase, portal venous phase and equilibrium phase in SHCC patients were respectively （14.62±13.74）%,（-6.85±8.28）% and （-14.23±9.64）% which were significantly lower than those of MRI （23.42±12.31）%,（-2.36±6.75）% and （-5.62±11.41）% （P〈0.05）. The quickly rise and drop type of CT enhanced curves in SHCC focuses was 65.38% which was higher than that of MRI 34.62%, the quickly rise and slowly drop type was 30.77% which was lower than that of MRI 61.54%, and their differences were statistically significant（P〈0.05）. Conclusion Compared with MRI, the enhanced curves of SHCC focuses in CT whose enhanced features are quickly rise and drop are conducive to show enhanced exit feature of SHCC focuses.