本文選題：小肝癌 + 肝臟加速容積采集技術(shù)　； 參考：《寧夏醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的探討3.0T MR肝臟加速容積采集技術(shù)聯(lián)合DWI對肝硬化背景上小肝癌檢出與定性的價值。方法收集經(jīng)病理、DSA介入證實的107例肝硬化背景上的小肝癌患者的影像資料。共發(fā)現(xiàn)病灶119個，單發(fā)病灶95個，兩個病灶的12例，所有小肝癌患者均行T1WI（正、反相位），T2WI，多期動態(tài)增強掃描（LAVA序列），，DWI掃描（b值800s/mm2）。比較并分析T1WI、T2WI、DWI、 LAVA增強各期及LAVA增強聯(lián)合DWI與LAVA增強對小肝癌的檢出率；T1WI（正、反相位）、T2WI、LAVA增強（Ａ組），T1WI（正、反相位）、T2WI、DWI（Ｂ組），二者聯(lián)合（Ｃ組）在小肝癌定性方面的價值。觀察各序列上小肝癌的信號特點，比較并分析各序列對小肝癌包膜的顯示，繪制病灶及周圍肝組織的時間信號強度曲線，測量小肝癌及其周圍肝組織ADC值。結(jié)果1、LAVA增強檢出小肝癌較DWI，T2WI，T1WI高，但LAVA增強與DWI比較無統(tǒng)計學(xué)差異。2、LAVA動脈期檢出小肝癌較門脈期或平衡期高，且具有統(tǒng)計學(xué)差異。3、LAVA增強顯示小肝癌包膜（數(shù)量及完整性）多于于T1WI、T2WI，其中T1WI又多于T2WI。4、LAVA增強聯(lián)合DWI較單獨使用LAVA增強檢出微小肝癌高，但兩者之間無明顯統(tǒng)計學(xué)差異。5、C組準(zhǔn)確定性小肝癌較A組、B組高，且具有統(tǒng)計學(xué)差異。6、小肝癌ADC值低于周圍肝組織，二者之間比較具有統(tǒng)計學(xué)差異。結(jié)論1、LAVA增強較DWI、T2WI、T1WI可以較好的檢出小肝癌。2、LAVA多期增強動脈期對肝硬化背景上小肝癌的檢出非常重要。3、LAVA增強（門脈期+平衡期）顯示小肝癌的包膜（數(shù)量、完整性）優(yōu)于T1WI、T2WI，其中T1WI優(yōu)于T2WI。4、LAVA增強聯(lián)合DWI可以減少對微小肝癌的漏診，DWI是LAVA增強有益的補充。5、LAVA增強聯(lián)合DWI有利于提高肝硬化背景上小肝癌的定性。6、本研究小肝癌ADC值低于周圍肝組織，說明小肝癌彌散受限。
[Abstract]:Objective to investigate the value of 3.0T Mr liver accelerated volume acquisition combined with DWI in the detection and characterization of small hepatocellular carcinoma (HCC) in the background of liver cirrhosis. Methods the imaging data of 107 patients with small liver cancer confirmed by DSA were collected. A total of 119 lesions, 95 single lesions and 12 cases of two lesions were found. All patients with small liver cancer were treated with T1WI (positive, inverse phase T2WI). To compare and analyze the positive rate of T1WI, T2WII DWI, LAVA enhancement combined with DWI and LAVA enhancement in small hepatocellular carcinoma (SHCC) and the value of T1WI (positive, reverse phase T2WILVA enhanced group A) T1WI (positive, negative phase T2WIDWIIB group) in the qualitative aspect of small hepatocellular carcinoma (SHCC). The signal characteristics of small hepatocellular carcinoma (HCC) on each sequence were observed and compared and analyzed. The time signal intensity curves of focus and surrounding liver tissue were plotted and the ADC values of small liver cancer and its surrounding liver tissue were measured. Results (1) the detection of small hepatocellular carcinoma was higher than that of DWI T2WIT T1WI, but there was no significant difference between LAVA enhancement and DWI. 2 the small HCC detected in arterial phase was higher than that in portal phase or equilibrium phase. The number and integrity of the capsule of small hepatocellular carcinoma was more than that of T1WIV T2WI, and T1WI was higher than that of T2WI.4Laiva combined with DWI, compared with that of LAVA alone. But there was no statistical difference between the two groups. The accurate characterization of small hepatocellular carcinoma in group C was higher than that in group A and B, and there was a statistical difference. The ADC value of small liver cancer was lower than that of surrounding liver tissue, and there was a statistical difference between the two groups. Conclusion (1) compared with DWI-T2WII-T _ 1WI, LAVA can be used to detect small hepatocellular carcinoma (SHC) in arterial phase. It is very important to detect SHCC in the background of cirrhosis. 3% LAVA enhancement (balance phase of portal vein) shows the number of small hepatocellular carcinoma (SHCC). T1WI is better than T2WI.4L LAVA combined with DWI can reduce the missed diagnosis of small hepatocellular carcinoma. It is a useful supplement of LAVA enhancement. 5% LAVA enhancement combined with DWI is helpful to improve the quality of small liver cancer in liver cirrhosis background. This study is to study small hepatocellular carcinoma. The ADC value was lower than that in the surrounding liver tissue. This indicates that the diffusion of small hepatocellular carcinoma is limited.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R735.7;R445.2

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