基于增强MRI分析乏血供肝胆低信号结节患者影像学特征及富血供进展率研究

Enhanced MRI Characteristics of Hypovascular Hypointense Nodules on Hepatobiliary Phase and the Rate of Progression to Hypervascular

目的分析增强MRI分析乏血供肝胆低信号结节患者影像学特征及富血供进展率。方法选取我院收治的2017年1月至2019年12月收治的肝硬化乏血供肝胆低信号结节患者150例,共193枚病灶。采用增强MRI诊断,比较增强MRI诊断患者结节类型、肝硬化程度、肝功能与病理结果符合情况,分析影像学特征及富血供进展率。结果增强MRI再生性结节、增生性结节病理符合率高于误诊率差异比较有统计学意义(P<0.05)。增强MRI诊断再生性结节中弥散分布结节、孤立性大结节病理符合率高于误诊率(P<0.05)。增强MRI诊断肝硬化轻度、中度、重度病理符合率高于误诊率(P<0.05)。MRI诊断肝功能分级病理符合率高于误诊率(P<0.05)。再生性结节动脉和门脉轻度增加率、动脉和门脉中度增加率、动脉和门脉重度增加率高于增生性结节(P<0.05)。结论增强MRI既能鉴别乏血供肝胆低信号结节类型,又能判断肝硬化程度及肝功能分级,有利于指导临床诊治。

Objective To investigate the enhanced MRI characteristics of hypovascular hypointense nodules on hepatobiliary phase and the rate of progression to hypervascular.Methods 150 patients with hypovascular hypointense nodules on hepatobiliary phase(193 lesions)in our hospital from January 2017 to December 2019 were enrolled,and received enhanced MRI examinations.Consistency of nodular type,cirrhosis degree,and liver function by enhanced MRI and pathological results was analyzed.The imaging features and the hypervascular progression rate were analyzed.Results The coincidence rate between MRI and pathological results for regenerative nodules and proliferative nodules was higher than that of misdiagnosis rate(P<0.05).The coincidence rate between MRI and pathological results for diffuse and solitary nodules was higher than that of misdiagnosis rate(P<0.05).The coincidence rate between MRI and pathological results for cirrhosis of mild,moderate and severe degrees was higher than that of misdiagnosis rate(P<0.05).The coincidence rate between MRI and pathological results for liver function grading was higher than that of misdiagnosis rate(P<0.05).The increase rate in the arteries and portal veins of mild,moderate and severe degrees was higher in regenerative nodules than in proliferative nodules(P<0.05).Conclusion Enhanced MRI can not only distinguish the type of hypovascular hypointense nodules on hepatobiliary phase,but also judge the degree of cirrhosis and the grading of liver function,which is helpful to guide the clinical diagnosis and treatment.