MR全身弥散加权成像在肝细胞癌M分期中的价值

目的探讨MR全身弥散加权成像(WB-DWI)在肝细胞肝癌(hepatic cell carcinoma,HCC)M分期中的价值。方法回顾性分析23例经临床、病理证实的HCC患者首次行WB-DWI检查的图像,统计肝外非淋巴结转移灶的分布及数目并进行对比分析。结果 WB-DWI未发现全身转移(M0)者11例,余12例均发现肝外转移灶(M1),主要为肺转移及骨转移。肺转移5例共14个病灶,WB-DWI发现12个,2个转移灶在WB-DWI上显示不清,结合胸部CT表现,肺部转移灶检出率较高(12/14,85.7%);骨转移8例共17个病灶,骨骼系统转移灶全部检出(17/17)。其余脏器脑部、脾、胰腺、肾上腺及泌尿生殖系统等均未见明显转移灶。全身非转移性病灶共计37处。结论 WB-DWI能够评估HCC患者全身情况,指导异常信号灶进行必要的相关检查,对于HCC患者M分期具有重要的价值。

Value of the Whole Body Diffusion Weighted Imaging (WB-DWI) in M Staging of Hepatic Cell Carcinoma

Objective To investigate the value of the whole body diffusion weighted imaging(WB-DWI) in M staging of hepatic cell carcinoma(HCC).Methods The WB-DWI images at the first time examination of 23 patients with HCC were analyzed.The distribution and the number of extrahepatic non lymph nodes metastases were calculated.Results On WB DWI images,there were no systemic metastases(M0) in 11 patients,and extrahepatic metastases(M1),mainly were lung and bone metastases,in 12 patients.14 lesions of lung metastasis were found in 5 cases,and 12 of them(12/14) were detected on WB-DWI images.Another 2 metastases were missed on WB-DWI and were showed on chest CT images.17 lesions of bone metastases were found in 8 cases,all of which(17/17)were detected on WB DWI images.There were no obvious metastases in the other organs such as the brain,spleen,pancreas,adrenal and genitourinary systems etc.37 non metastatic lesions were found on WB DWI.Conclusion WB DWI can assess the general situation of patients with HCC,and guide to execute necessary examination for abnormal signal lesions.It has an important value for assess M staging in patients with HCC.