高场强MRI对肝硬化退变结节与小肝癌诊断与鉴别诊断价值分析

The Value of High Field MRI in the Diagnosis and Differential Diagnosis of Liver Cirrhosis Degenerative Nodules and Small Hepatocellular Carcinoma

目的探讨高强场MRI对肝硬化退变结节与小肝癌诊断与鉴别诊断价值。方法收集肝硬化患者40例(退变结节50个),以及同期小肝癌患者36例(小肝癌结节50个),对两组患者MRI资料进行回顾性分析。结果退变结节组在T1W1呈高信号的有6例,占12%,在T1W1呈等信号的有44例,占88%。小肝癌组在T1W1呈等信号的有8例,占16%;在T1W1呈低或等信号的有42例,占84%。两组同、反相位比较,在退变结节组有10个结节在同、反相位T1W1呈等信号,占20%,其余80%的呈稍高信号。小肝癌组中12个结节同相位T1W1呈稍高信号,占24%,其中7个结节反相位T1W1呈低信号,38个结节同、反相位呈等或低信号,占76%。两组患者在T2W1的表现,退变结节组的50个结节全部呈低信号;而在小肝癌组中,50个结节46个结节呈稍高或不均匀等或高信号,占92%,仅4个结节呈低信号,占8%;两组比较有统计学差异(P <0. 05)。两组T2WI抑脂比较显示,退变结节组的50个结节全部呈低信号,而在小肝癌组中,50个结节46个结节呈稍高或不均匀等或高信号,占92%,仅4个结节呈低信号,占8%。两组Gd-DTPA动态三期增强扫描显示退变结节组多数结节呈现缓升速降,而小肝癌组大多呈现速升速降。结论高场强磁共振成像综合不同信号影像的表现及增强扫描的特点,可以有效区分大部分退变结节与小肝癌。

Objective To investigate the value of high intensity field MRI in the diagnosis and differential diagnosis of liver cirrhosis degenerative nodules and small hepatocellular carcinoma. Methods 40 cases of hepatocirrhosis( 50 degenerative nodules) and 36 cases of small liver cancer( 50 small hepatoma nodules) in the same period were collected,and the data of the 2 groups of patients with MRI were compared. Results In the degenerative nodule group,there were 6 cases of hyperintensity in T1W1,accounting for 12%,and 44 cases in T1W1 showed an ISO signal,accounting for 88%. In the small liver cancer group,there were 8 cases of equal signal in T1W1,accounting for 16%,in the right 42 cases with low or equal signals in T1W1,accounting for T2W1 in 84%. The 2 groups were compared in the same phase and in opposite phase. In the degenerative nodule group,10 nodules showed equal signals in the same and opposite phase T1W1,accounting for 20%,and the remaining 80% showed a slightly higher signal. T1W1 in 12 small nodules showed a slightly higher signal in the small hepatocarcinoma group,accounting for 24%. Among them,7 nodules had a low signal in opposite phase T1W1,and 38 nodules showed equal or low signal in the same phase,accounting for 76%. The performance of T2W1 in the 2 groups of patients,The 50 nodules in the degenerative nodule group all showed low signal;in the small liver cancer group,46 nodules showed a slight high or uneven signal or high signal,accounting for 92%,only 4 nodules Low signal,accounting for 8%;there was a statistically significant difference between the 2 groups( P < 0. 05). Comparison of T2W1 lipid inhibition between the 2 groups showed that all 50 nodules in the degenerative nodule group showed low signal,while in the small liver cancer group,46 nodules showed a slight high or uneven or high signal in 50 nodules. 92%,only 4 nodules showed a low signal,accounting for 8%. The dynamic three-phase enhanced Gd-DTPA scan showed that most of the nodules in the degenerative nodule group showed a slow rise and fall,while the small liver cancer group showed a rapid increase and decrease. Conclusion High field magnetic resonance imaging( MRI) combined with the performance of different signal images and enhanced scanning characteristics can effectively distinguish most degenerative nodules from small liver cancer.