浅析微小肝癌是否含脂及假包膜核磁共振信号特征与手术切除术后复发时间的相关性

Analysis of the correlation between lipid content and pseudocapsule MR signal characteristics of micro hepatocellular carcinoma and recurrence time after surgical resection

目的:分析微小肝癌是否含脂及假包膜核磁共振(MR)信号特征与手术切除术后复发时间的相关性。方法:回顾性分析2018年9月—2019年12月收治的84例微小肝癌患者的临床资料,均接受MR平扫及动态增强扫描,分析各自MR征象,随访24个月,分析复发情况与是否含脂及假包膜的相关性。结果:84例微小肝癌患者随访24个月,复发率42.86%。经MR检查,病变形态为小结节状或分叶状,边缘清晰。MR弥散加权成像(DWI)高信号95.24%,T2加权像(T2WI)高信号86.90%,T1加权像(T1WI)低信号89.29%。动态增强呈“快进慢出”占27.38%,“快进快出”占72.62%。复发时间<12个月组和12~24个月组患者的年龄、性别、肿瘤直径等资料比较,差异无统计学意义(P>0.05)。复发时间12~24个月组病变内含脂率78.57%,假包膜强化发生率85.71%,高于复发时间<12个月组的22.73%,40.91%,差异有统计学意义(P<0.05)。结论:MR平扫及动态增强扫描微小肝癌具有特异性,并能根据病灶含脂、假包膜提示患者术后病灶复发情况。

Objective:To analyze the correlation between the lipid content and pseudocapsule magnetic resonance imaging(MR)signal characteristics of small hepatocellular carcinoma and the recurrence time after surgical resection.Methods:The clinical data of 84 patients with minimal liver cancer treated in our hospital from September 2018 to December 2019 were analyzed retrospectively.All patients underwent plain and dynamic enhanced MR scanning,analyzed their MR signs,followed up the patients for 24 months,and judged whether they contained fat and false capsule according to the recurrence.Results:All 84 patients with minimal hepatocellular carcinoma were followed up for 24 months.The recurrence rate was 42.86%.MR examination of 84 cases of micro hepatocellular carcinoma showed that the lesion was nodular or lobulated,and the edge was clear.DWI high signal 95.24%,T2WI high signal 86.90%,T1WI low signal 89.29%.The dynamic enhancement showed that'fast in and slow out'accounted for 27.38%,and'fast in and fast out'accounted for 72.62%.There was no significant difference in age,sex and tumor diameter between the recurrence time<12 months group and the recurrence time 12~24 months group(P>0.05).The incidence of fat content and pseudocapsule enhancement in the group with recurrence time of 12~24 months was 85.71%,which was higher than 22.73%and 40.91%in the group with recurrence time of less than 12 months(P<0.05).Conclusion:MR plain scan and dynamic contrast-enhanced scan of small hepatocellular carcinoma are specific,and can prompt the recurrence of postoperative lesions in patients according to the lipid content and pseudocapsule of the lesions.