菲立磁增强MRI检测肝脏占位病变与三期动态增强CT扫描的比较研究

目的　比较菲立磁增强MRI和增强CT扫描在肝脏实性占位病变检测中的应用价值。方法　对 18例肝内局灶性占位患者行MR平扫及菲立磁增强扫描。观察肝脏与病灶信号强度变化 ,形态及数目 ,比较增强前后T2 WI病灶及肝脏的信噪比 (SNR)及对比噪声比 (CNR) ,做出MRI定性诊断 ,并与增强CT扫描诊断进行比较。其中肝细胞肝癌 4例 ,复发性肝癌 4例 ,转移瘤 4例 ,肝血管瘤 6例。结果　菲立磁增强明显降低正常肝组织信号强度 ,而恶性肿瘤的信号强度无强化 ,病灶—肝脏信噪比增加可清晰显示病变 ,并发现新病灶。肝血管瘤的血池效应与增强CT扫描比较有鉴别诊断意义。结论　做为增强CT扫描和Gd -DTPAMR增强的补充方法 ,SPIO增强MRI对肝脏占位病变的显示 ,小病灶发现和定性诊断中有重要的临床意义

A Comparative Study of Feridex Enhanced MRI and Enhanced CT Scan for Detection of Focal Hepatic Lesions

Objective To compare Feridex(snperparamagnetic iron oxide,SPIO)enhanced MRI and enhanced spiral CT scan in the detection of hepatic focal solid lesions.Methods Couventional plain and Feridex-enhanced MR scanning were peformed in 18 cases with suspected hepatic neoplasm.The effects of Feridex on signal intensity of the liver.SNR of lesion cantly decreased and CNR of lesion liver were significantly.The number of lesions on T 2 WI and the signal intensity of liver and lesions demonstrated on plain and enhanced scans were obseved and analyzed.The diagnosis was compared with enhanced CT scan.Diseases:primary hepato-cellular carcinoma(HCC n=4)metastases(n=4) recurrent carcinoma(n=4)hemangioma(n=6).Results After the injection of Feridex the signal intensity of normal liver tissue reduced significantly while the signal intensity of malignant tumon showed on marked changes.Feridex-enhanced MRI clearly displayed more lesions on T 2WI than plain scanming did.To compare enhanced CT scan the "blood-pool effed"of hemangiona was very helpful in diagnosis.Conclusion As a edditional method of enhanced CT scan and Gd-DTPA enhanced MRI,SPIO-enhancement is very helpful to find and diagroning the focal hepatic lesions.