【摘要】：目的探討高場強MRI對于肝硬化退變結(jié)節(jié)以及小肝癌診斷、見表診斷的臨床應(yīng)用價值。方法選擇2014年1月至2016年1月期間在我院就診的18例共24個肝硬化退變結(jié)節(jié)(DN)以及15例共26個小肝癌(SHCC)患者的MRI圖像作為研究資料,對33例患者的MRI圖像進行回顧性分析。結(jié)果在18例24個DN患者中,4個在同反相位T1WI上呈現(xiàn)等信號,比例是16.67%,其余20個呈稍高信號,比例為83.33%;在15例26個SHCC患者中,6個(23.08%)在同相位T1WI上呈稍高信號,另有20個(76.92%)在同、反相位Tl WI上呈低信號或等信號。在T2WI上DN組患者的24個結(jié)節(jié)均呈現(xiàn)低信號,而SHCC組的26個結(jié)節(jié)中,24個呈現(xiàn)不均勻等信號、稍高信號或高信號,所占比例是92.31%,僅2個在T2WI上呈現(xiàn)低信號,比例為7.69%。在Gd-DTPA動態(tài)增強掃描中,發(fā)現(xiàn)DN組中14例患者的15個DN是呈緩升速降型的,比例為93.33%,其中13個DN可發(fā)現(xiàn)不規(guī)則網(wǎng)狀纖維隔強化,比例86.67%,僅1個DN呈假包膜樣強化;SHCC組中14例患者24個SHCC是呈速升速降型的,比例為92.31%,其中包膜強化有17個,比例為70.83%。結(jié)論高場強的MRI能夠有效的凸顯肝硬化患者退變結(jié)節(jié)和早期小肝癌的相關(guān)特征,從而做出診斷和見表診斷,幫助臨床提高診斷率,從而制定后續(xù)治療方案。
[Abstract]:Objective to investigate the clinical value of high field MRI in the diagnosis of degenerative nodules of cirrhosis and small hepatocellular carcinoma (HCC). Methods from January 2014 to January 2016, MRI images of 18 patients with 24 degenerative nodules of cirrhosis and 15 patients with (SHCC) of small liver cancer were selected as the data. The MRI images of 33 patients were analyzed retrospectively. Results of the 18 patients with 24 DN, 4 showed equal signal on the ipsilateral T1WI, the proportion was 16.67 and the other 20 showed slightly higher signal intensity (83.33%). Of the 15 patients with 26 SHCC, 6 (23.08%) showed slightly hyperintense signal on the same phase T1WI, and 20 (76.92%) showed low or equal signal on the ipsilateral Tl WI. On T2WI, 24 nodules of DN group showed low signal intensity, while 24 of 26 nodules in SHCC group showed heterogeneous isointense signal, slightly high signal intensity or high signal intensity, accounting for 92.31%, and only 2 showed low signal intensity on T2WI. The ratio is 7.69. In Gd-DTPA dynamic enhanced scanning, 15 DN of 14 patients in DN group were found to be of slow ascending and fast descending type, the proportion was 93.33.The irregular reticular fibrous septum was found in 13 DN patients, and the proportion was 86.67%. Only one DN showed pseudocapsular enhancement. In the SHCC group, 24 SHCC of 14 patients were of rapid ascending and fast descending type, the proportion was 92.31, of which 17 cases were capsule enhancement, the proportion was 70.83%. Conclusion High-field MRI can effectively highlight the features of degenerative nodules and early small hepatocellular carcinoma in patients with liver cirrhosis, so as to make diagnosis and see table diagnosis.
【作者單位】： 湖北科技學院附屬第一醫(yī)院(湖北省咸寧市中心醫(yī)院)放射科;
【基金】：湖北省衛(wèi)生計生政策類專項科研項目(WJ2015GB032) 湖北科技學院科研項目(KY 12072;LCZX201508)
【分類號】：R735.7;R575.2;R445.2

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