布-加综合征合并肝细胞癌的普美显增强磁共振成像特征分析

Analysis of Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging Features of Budd-chiari Syndrome Complicated with Hepatocellular Carcinoma

目的探讨布-加综合征(BCS)背景下肝细胞癌(HCC)的普美显(Gd-EOB-DTPA)磁共振成像特征。方法回顾性分析14例有BCS背景的肝细胞癌患者和32例无BCS背景的肝细胞癌患者的临床资料,其中有BCS背景的HCC病灶24个,无BCS背景的HCC病灶41个,所有的患者均进行普美显增强MRI检查。比较两组肝细胞癌患者的MRI特征(强化模式、包膜、囊变坏死、出血、腹水等)及差异性。结果门静脉期有BCS背景的肝细胞癌病灶呈高信号明显多于无BCS背景的病灶,延迟期有BCS背景的肝细胞癌病灶呈高信号多于无BCS背景的病灶,差异均有统计学意义(P<0.05),肝胆期两者信号差别无统计学意义。有BCS背景的患者中有腹水的比例、女性患者比例明显高于无BCS背景的患者,病灶内出血比例低于无BCS背景的病灶,差异均有统计学意义(P<0.05)。结论有BCS背景和无BCS背景的肝细胞癌在门静脉期及延迟期显示不同的增强模式,在肝胆期无显著差异。

Objective To investigate the Gd-EOB-DTPA magnetic resonance imaging features of hepatocellular carcinoma(HCC)under the background of Budd-Chiari syndrome(BCS).Methods The clinical data of 14 patients with hepatocellular carcinoma with BCS background and 32 patients with hepatocellular carcinoma without BCS background were analyzed retrospectively,including 24 HCC lesions with BCS background and 41 HCC lesions without BCS background.All patients were examined by Gd-EOB-DTPA enhanced MRI.The MRI features(enhancement mode,capsule,cystic degeneration and necrosis,hemorrhage,ascites,etc.)and differences between the two groups were compared.Results The hyperintense of HCC lesions with BCS background was significantly more than that without BCS background in the portal vein phase,and the hyperintense of HCC lesions with BCS background was significantly more than that without BCS background in the delayed phase,and the differences were statistically significant(P<0.05).There was no significant difference in signal intensity between the two groups in hepatobiliary phase.The proportion of ascites and female patients with BCS background was significantly higher than that of patients without BCS background,and the proportion of intrafocal hemorrhage was lower than that of lesions without BCS background,the difference was statistically significant(P<0.05).Conclusion Hepatocellular carcinoma with and without BCS background showed different enhancement patterns in portal venous phase and delayed phase,but there was no significant difference in hepatobiliary phase.