钆塞酸二钠对比剂增强MR在小肝癌诊断中的应用

Application of gadoxetic acid disodium enhanced MR scan in the diagnosis of smal hepatocellular carcinoma

目的:探讨钆塞酸二钠(Gd-EOB-DTPA)对比剂在磁共振(MR)增强扫描中对小肝癌诊断的应用价值。方法:收集41例经临床或病理证实的小肝癌患者,对所有患者行MR平扫加Gd-EOBDTPA对比剂增强扫描,分析其影像学表现。结果:在41例小肝癌患者中共检出病灶49枚,单枚病灶35例,2枚病灶4例,多枚病灶2例。MR平扫中,T_1WI和T_2WI信号特点以稍长T_1稍长T_2为主(占51.2%),DWI以稍高或高信号为主(占78.0%)。Gd-EOB-DTPA增强MR中,动脉期高信号比例为63.4%,门脉期等信号为61.0%,延迟期稍低信号及低信号为90.2%,肝胆期低信号为92.7%。全部病灶的平扫准确率为78.0%,动态增强时段的前三期为85.4%,动态增强肝胆期达100%。结论:Gd-EOB-DTPA增强MR对小肝癌的诊断准确性高,尤其表现在动态增强MR肝胆期。

Objective:To discuss the application value of contrast agent of gadoxetic acid disodium(Gd-EOB-DTPA)in the diagnosis of small hepatocellular carcinoma by using MR enhanced scan.Methods:41patients with small hepatocellular carcinoma who were confirmed by clinical surgery or pathological experiment were enrolled in this research.And all of them were implemented MR plain scan and Gd-EOB-DTPA contrast enhanced MR scan,respectively.And then these relevant imaging manifestations were analyzed.Results:A total of49lesions were found out from41patients,among whom35patients were single lesion,4patients were2lesions and2patients were multiple lesions.In MR plain scan,the signal characteristics of T1WI and T2WI were that slight long T1and slight long T2were main part(51.2%),and main manifestation of DWI was slight high or high signal(78.0%).While in Gd-EOB-DTPA contrast enhanced MR scan,the high signal ratio of arterial phase was63.4%,the equisignal ratio of portal vein phase was61.0%,the slight low and low signal ratio of delayed phase was90.2%,and the low signal ratio of hepatobiliary phase was92.7%.And the accuracy rate of plain scan for all of lesions was78.0%,and the top three stages of dynamically enhanced phase was85.4%,and the hepatobiliary stage of dynamic enhanced phase was100%.Conclusion:Gd-EOBDTPA enhanced MR has high accuracy in diagnosis for small hepatocellular carcinoma,especially in the hepatobiliary phase of dynamic enhanced MR.