肝细胞癌术后MRI表现

目的研究肝细胞癌术后肝脏切缘单纯术后改变与复发的MRI表现特征。方法手术后病理证实为肝细胞癌、术后定期复查或临床怀疑复发采用MRI检查的病例共20例。MRI包括：T1WI横断面平扫和横断面、冠状面增强扫描．VIBE序列扫描．T2WI横断面平扫，冠状面TrueFisp序列扫描。结果肝脏切缘单纯术后改变13例、复发6例、可疑复发1例；残肝内复发12例，其中侵犯左、右肝管及肝总管3例；肝门、门腔间隙及腹膜后淋巴结肿大3例，腹膜、肠系膜广泛种植2例。结论MRI能鉴别肝脏切缘单纯术后改变和复发，早期发现肝内、外复发灶。

MR Imaging Features of Residual Liver and Tumor Recurrence after Hepatic Resection for Hepatocellular Carcinoma

Objective To investigate the MR imaging (MRI) appearances of postoperative residual liver after hepatic resection for hepatocellular carcinoma (HCC) and the MRI features of tumor recurrences.Methods Twenty patients with previous surgical resection of HCC underwent MR examination of upper abdomen for routine follow-up study or due to clinical suspicion of tumor recurrence. MRI protocol included T1W axial unenhanced images and Gadolinium-enhanced sequences, Gadolinium-enhanced VIBE sequence, unenhanced T2W axial images and coronal TrueFisp sequence.Results Thirteen patients showed normal edge of surgical resection, while 6 patients demonstrated MR signs of incision edge recurrence of HCC and 1 patient was suspicious of tumor recurrence at the incision edge. Among the 20 patients, 12 had MRI features of tumor recurrence of the residual liver, including invasion of left, right and common hepatic ducts 3 cases. Three patients had metastatic lymphadenopathy in portal hepatis, portacaval space and retroperitoneal space. Two patients showed extensive tumor implantation of peritoneum and mesentery. Conclusion MRI is effective in differentiating normal surgical incision edge of residual liver from tumor recurrence. It is also very useful for the early detection of intra-hepatic and extra-hepatic tumor lesions.