小肝癌与肝硬化结节的MRI征象特点及其鉴别诊断价值

MRI features of small hepatocellular carcinoma and cirrhotic nodules and its value of differential diagnosis

目的:探讨小肝癌、肝硬化结节的MRI征象特点及鉴别诊断价值。方法:抽取2018年3月至2019年12月在郑州大学附属洛阳中心医院接受治疗的70例小肝癌、肝硬化结节患者作为研究对象,入选患者经病理检查、手术等手段证实病灶共计104个,其中小肝癌52个,肝硬化退变结节26个,肝硬化再生结节26个。予以全部入选患者磁共振成像(MRI)检查,观察分析小肝癌、肝硬化退变结节以及肝硬化再生结节3种病变类型的MRI征象特征。探究MRI在小肝癌、肝硬化结节鉴别诊断中的应用价值。结果:小肝癌的MRI征象主要为T1WI低信号、T2WI高信号,病灶的动态增强时间-信号曲线主要表现为速升速降型。假包膜征象较为常见,同时存在分隔状镶嵌征。肝硬化退变结节的MRI征象主要为T1WI较均匀等信号或高信号、T2WI低信号,动态增强时间-信号曲线表现为速升缓降型。肝硬化再生结节的MRI征象主要为T1WI高信号、T2WI低信号,动态增强扫描显示病灶的动态增强时间-信号曲线均表现为缓慢上升型。结论:MRI在鉴别诊断小肝癌、肝硬化结节中具有理想的应用价值,小肝癌、肝硬化退变结节以及肝硬化再生结节的MRI征象特点有差异,可将其作为小肝癌、肝硬化结节的鉴别与诊断依据。

Objective:To investigate the magnetic resonance imaging(MRI)features of small hepatocellular carcinoma(SHCC)and cirrhotic nodules,and its value of differential diagnosis.Methods:A total of 70 patients with SHCC or cirrhotic nodules who were diagnosed and treated in Luoyang Central Hospital Affiliated to Zhengzhou University from March 2018 to December 2019 were selected as the research objects.The selected patients had a total of 104 lesions confirmed by pathological examination and surgery,including 52 cases SHCC,26 cases degenerative nodules in liver cirrhosis,and 26 cases regenerating nodules in liver cirrhosis.MRI examinations were performed on all selected patients to observe and analyze the MRI features of the three types of lesions,including SHCC,degenerative nodules in liver cirrhosis,and regenerating nodules in liver cirrhosis.And the application value of MRI in the differential diagnosis of SHCC and cirrhotic nodules was analyzed.Results:The MRI signs of SHCC were mainly low signal on T1WI,and high signal on T2WI.the dynamic enhancement time-signal curve of the lesion mainly showed rapid increase and decrease.Pseudocapsule signs were more common,with compartmentalized mosaic signs at the same time.MRI signs of degenerative nodules in liver cirrhosis were mainly equal signal or high signal on T1WI,low signal on T2WI,and the dynamic enhancement time-signal curve showed rapid rise and slow decline.MRI signs of regenerating nodules in liver cirrhosis were mainly high signal on T1WI,and low signal on T2WI;the dynamic enhancement scan showed that the dynamic enhancement time-signal curve of the lesion slowly increasied.Conclusions:MRI has ideal application value in the differential diagnosis of SHCC and cirrhotic nodules.SHCC,cirrhotic degenerative nodules in liver cirrhosis,and regenerating nodules in liver cirrhosis have differences in MRI signs,so the MRI signs can be regarded as reference to diagnosis of the three types of lesions.