肝内局灶性病变菲立磁增强MRI-组织病理相关性研究

目的分析肝内局灶性病变菲立磁增强信号强度变化与Kupffer细胞计数的关系。方法搜集行菲立磁增强MR扫描并经手术病理证实的12例16个肝细胞癌(HCC)病灶以及良性病变9例16个病灶,分别计算局灶性病变相对于肝组织的Kupffer细胞的比率以及菲立磁增强前后T1WI、T2WI信号的相对比率,并进行相关性分析。结果良、恶性肝内局灶性病变间Kupffer细胞比率差异有统计学意义,随着HCC分化程度的降低,病灶内Kupffer细胞计数比率呈下降趋势(P<005)。T2WI强化比率与Kupffer细胞计数比率呈负相关(r=-0780,P<005);T1WI强化比率与Kupffer细胞计数比率呈正相关(r=0389,P<005)。结论肝内局灶性病变间Kupffer细胞计数比率的明显差异是菲立磁增强MRI鉴别肝内良、恶性病灶的基础,T2WI序列能有效地鉴别肝内良、恶性疾病,是鉴别肝内良恶性局灶性病变的MR检查首选序列。

The study on the correlation of feridexs-enhanced MRI with histological pathology in local hepatic lesions

Objective To investigate the correlation between the conspicuity of local hepatic lesions on feridexs-enhanced MR images and the number of Kupffer cells in the hepatic lesions in histopathologic findings, as compared with that in the background liver. Methods Thirty-two histologically proven local hepatic lesions including 4 well-differentiated HCCs, 8 middle-differentiated HCCs, 4 poor-differentiated HCCs, 2 focal nodule hyperplasia, 4 hepatic abscesses, 1 local inflammatory nodule, 5 dysplastic nodules, and 4 cavernous hemangiomas were retrospectively studied in 20 patients? who underwent feridexs-enhanced MRI. The ratio of the Kupffer-cell and the ratio of the intensity of the lesion to that of the nontumorous liver tissue on T_1WI, T_2WI sequences were counted respectively, and the correlation between the ratio of Kupffer-cell and the ratio of intensity of lesion was analyzed. Results There were significant differences for the ratio of Kupffer cell between the benign conditions and HCCs. As the differentiation grade of HCC went upward, the ratio of Kupffer cell of HCC decreased. The ratio of T_2WI-SPIO intensity of the lesion are correlated inversely with Kupffer-cell-count ratio in local hepatic lesion(r=-0.780,P<0.05), While the ratio of SPIO-intensity was positively correlated with Kupffer-cell-count in local hepatic lesion on T_1WI sequence~(r= 0.389,P<0.05). Conclusion The ability of lesion characteristization at feridexs-enhanced MR imaging depends on the difference in the number of Kupffers cells within the lesion. T_2WI is the best sequence for the characterization of local hepatic lesions.