多层螺旋CT及磁共振成像三期扫描在不典型肝血管瘤和肝细胞癌中的诊断价值

Diagnostic value of multi-slice spiral CT and MRI three phase scanning in atypical hepatic hemangioma and hepatocellular carcinoma

目的探讨多层螺旋CT及磁共振成像(MRI)三期扫描在不典型肝血管瘤和肝细胞癌中的诊断价值。方法选取武胜县中医医院2014年1月-2018年2月收治的不典型肝血管瘤和肝细胞癌患者120例,其中肝血管瘤54例,肝细胞癌66例。收集患者多层螺旋CT及MRI三期扫描的影像学资料,分析不典型肝血管瘤和肝细胞癌影像学特点。结果肝血管瘤CT动脉期共检出病灶61个,增强扫描主要表现为"早出晚归"或"慢进慢出"的强化特点,病灶呈高密度,MRI病灶均呈结节样强化;门脉期病灶增强范围逐渐扩大,密度较前下降,可呈现低密度病灶,MRI示中央大部分仍未强化,T1WI多呈低信号,T2WI多呈异常高信号,可见"灯泡征";延迟期病灶均出现明显强化,呈现等密度填充,MRI示周边持续环状强化。肝细胞癌动脉期共检出病灶78个,多表现为均匀强化灶,呈"快进快出"特点,MRI多表现为不均匀明显强化,T1WI多呈稍低信号,T2WI多呈不均匀稍高信号,边界欠清晰;门脉期及延迟期病灶密度降低,MRI强化多明显降低。结论多层螺旋CT与MRI三期扫描下不典型肝血管瘤和肝细胞癌各具特点,结合使用对两种疾病的鉴别诊断具有较高的应用价值。

Objective To investigate the diagnostic value of multi-slice spiral CT and MRI three phase scanning in atypical hepatic hemangioma and hepatocellular carcinoma.Methods A total of 100 cases of patients atypical hepatic hemangioma and hepatocellular carcinoma were selected from January 2014 to February 2018 in Wusheng County Hospital of Traditional Chinese Medicine,there were 54 cases of hepatic hemangioma and 66 cases of hepatocellular carcinoma.The imaging data of patients with multi-slice spiral CT and MRI three-phase scanning were collected,analysis of imaging features of atypical hepatic hemangioma and hepatocellular carcinoma.Results 61 lesions were detected in the CT arterial phase of the hepatic hemangioma.The enhanced scan was mainly characterized by"early arrival late return"or"slow slow progress".The focus was high density,and the focus of MRI was nodular enhancement.The enhancement range of the portal phase was gradually enlarged and the density was lower than that of the former.The focus of the focus was low density,MRI showed the central majority still.No enhancement,most of the T1 WI showed low signal,T2 WI more abnormal high signal,"light bulb sign";the delay stage of the focus was obviously enhanced,showing equal density filling,MRI surrounding continuous ring enhancement.A total of78 lesions were detected in the arterial phase of hepatocellular carcinoma.Most of them were homogeneous intensification foci,which were characterized by"fast forward and fast out".MRI was characterized by inhomogeneous and obvious enhancement,T1 WI was a little low signal,T2 WI was unevenly and slightly high signal,and the boundary was not clear;the density of the lesions in the portal and delayed phase decreased,and the enhancement of MRI was significantly reduced.Conclusion The characteristics of atypical hepatic hemangioma and hepatocellular carcinoma under the three phase scan of multislice spiral CT and MRI are of high clinical value for the differential diagnosis of two diseases.