1.5T MR多序列检查在CT等密度小肝癌中的临床应用价值

The clinical application value of 1.5T MR multiple sequence inspection on the small hepatocellular carcinoma of CT equidensity

目的探讨1.5T MR多序列检查在CT等密度小肝癌患者中的诊断价值。方法2015年1月至2018年1月连云港市第二人民医院影像科收治的20例（22个病灶）CT平扫呈等密度小肝癌患者，经术后病理、随访或经导管肝动脉化学治疗栓塞（TACE）均证实为小肝癌。对所有患者均行1.5T MR常规扫描（T1WI、T2WI、DWI）及增强扫描，分析MR扫描各序列的信号特征及强化方式。结果等密度小肝癌大部分呈长T1、长T2信号特征且位置表浅，T1WI、T2WI、DWI序列、动脉期、门静脉期小肝癌显示率分别为72.7%、81.8%、100%、90.9%、81.8%。病灶基本呈富血供、快进快出特点，其中以DWI序列显示率最高，结合增强扫描强化特点，基本能够对等密度小肝癌作出定位定性诊断。结论1.5T MR多序列检查能够早期发现CT平扫等密度小肝癌，避免漏诊；多个检查序列中，DWI序列发现病灶阳性率最高，结合MR增强扫描，能够明显提高小肝癌检出率及诊断率，在肝癌高危患者体检、随访复查中具有较高的临床应用价值。

Objective To explore diagnostic value and clinical significance of 1.5T MR multi-sequence inspection in hepatoma of equidensity scanning. Methods This retrospective study involved the patients admitted between January 2015 and January 2018. A total of 20 patients （22 lesions）who underwent the small hepatocellular carcinoma and the equidensity scanning image of CT were confirmed by postopera- tive pathology,follow-up or transcatheter arterial chemoembolization. All Patients were performed by 1.5T MR scanning（ T1WI, T2WI, DWI ）and enhancement scanning. Analyse The signal characteristics of each se- quence and the way of strengthening of MR scanning were analyzed. Results The most small hepatocellu- lar carcinoma had the feature of long T1 and long T2 signal and shallow location, The displayed rates of the small hepatocellular carcinoma in T1WI, T2WI, DWI equence, Arterial phase and portal phase are 72. 7% , 81.8% ,100% ,90. 9% ,81.8%. The most lesions had the characteristics of rich blood supply and fast in fast out, especially DWI sequence had the highest displayed rate, Combined the characteristics of enhanced scanning strengthening, mostly the small hepatocellular carcinoma were recognized. Conclusion 1.5T MR can find the small hepatocellular carcinoma of CT equidensity early, avoid misdiagnosis, DWI has the high- est positive rate among all the multisequence inspection, combined with the MR enhancement scanning, the detection rate and diagnosis rate of the small hepatocellular carcinoma are obviously improved.