DWI、T2WI及MRI动态增强扫描成像对不同分化小肝细胞癌的定量诊断研究

Quantitative Diagnosis of Differentiated Small Hepatocellular Carcinoma by DynamicEnhanced Scanning with DWI,T2 WI and MRI

目的探讨弥散加权成像(DWI)、T2加权成像(T 2WI)及磁共振(MRI)动态增强扫描成像对不同分化小肝细胞癌(small hepatocellular carcinoma,SHCC)的定量诊断价值。方法回顾性分析35例乙肝肝硬化经病理证实为SHCC患者,均行DWI、T 2WI和动态增强扫描,分析病灶在6个序列信号特征和强化特征。结果①在35例患者中T 2WI检测出SHCC有32例,检测率为91.43%,有3例未检出。DWI检出35例,两者之间在检出率上比较差异不显著(P>0.05)。②6例高分化SHCC中有4例T 2WI为稍高信号,高信号和稍低信号分别为1例;19例中分化SHCC中有17例T 2WI为稍高信号或高信号,1例为混杂信号。中低分化8例T 2WI均表现为稍高/高信号。低分化中2例均表现为稍高/高信号。结论DWI较T 2WI对乙肝肝硬化SHCC信躁比和载波躁声比更清晰,联合两者进行病灶观察能提高诊断准确性。

Objective To investigate the quantitative diagnostic value of diffusion weighted imaging(DWI),T2 weighted imaging(T 2WI)and dynamic enhanced magnetic resonance(MRI)in differentiated small hepatocellular carcinoma(SHCC).Methods 35 patients with hepatitis B cirrhosis confirmed by pathology as SHCC were retrospectively analyzed.All patients underwent DWI,T 2WI and dynamic contrast-enhanced scanning.The signal characteristics and enhancement characteristics of the lesions in 6 sequences were analyzed.Results Among the 35 patients,31 cases were detected SHCC by T 2WI,the detection rate was 88.57%,and 4 cases were not detected.There were 35 cases detected by DWI,and there was no significant difference in the detection rate between the 2 groups(P>0.05).(2)In highly differentiated SHCC,there were 4 cases with slightly high signal intensity on T 2WI,1 case with slightly low signal intensity and 1 case with slightly high signal intensity on T 2WI and 1 case with mixed signal intensity in moderately differentiated SHCC.T 2WI showed slightly higher/higher signal intensity in moderate to low differentiation.Two of the poorly differentiated patients showed slightly higher/higher signal intensity.Conclusion DWI has the highest signal-to-noise ratio and carrier-to-noise ratio of SHCC in the background of hepatitis B cirrhosis,which is significantly higher than that of T 2WI.Therefore,dynamic enhanced multi-sequence imaging and DWI should be combined to observe the lesions in order to improve the accuracy of qualitative diagnosis of the lesions.