3.0T磁共振三维容积内插屏气检查在小肝癌诊断中的应用

目的 探讨3.0T磁共振(MRI)三维容积内插屏气检查(3D-VIBE)序列动态增强扫描对小肝癌的检出率,并评价其在小肝癌定性诊断中的价值.方法 回顾性分析经临床手术及病理学检查证实的61例小肝癌患者的影像学资料,用3.0T磁共振扫描仪进行平扫及3D-VIBE序列动态增强扫描.分析病灶在3D-VIBE序列动态增强扫描各个时相的信号特点及强化特征,评价各平扫及增强序列对病灶的检出率及定性诊断价值.结果 6l例患者手术共发现66个病灶,49个病灶见假包膜形成.T1加权成像(T1WI)发现病灶43个(65.15%),19个(38.78%)见假包膜.T2加权成像(T2WI)发现病灶53个(80.30%).3D-VIBE序列动态增强扫描共发现65个病灶(98.48%),35个(71.43%)见假包膜.3种不同序列对病灶检出率的差异具有统计学意义(X2=24.197,尸<0.05).平扫(T1WI+T2WI)与3D-VIBE序列动态增强扫描对病灶的定性准确率的差异也具有统计学意义(X2=66,P<0.05).结论 3.0T MRI 3D-VIBE序列动态增强扫描的扫描速度快,可清楚显示动脉期、门静脉期及实质期等各个时相的特点,这不仅有利于发现平扫所不能发现的小病灶,而且可以通过绘制时间一信号强度曲线协助诊断.对肝癌癌灶的检出及鉴别诊断具有重要价值.

Application of 3.0F MRI 3D-VIBE dynamic contrast-enhanced in the diagnosis of small hepatocellular carcinomas

Objectives To investigate the detection rate of small hepatocellular carcinomas using 3.0T MRI 3D-volumetric interpolated breath-hold examination (VIBE) sequence dynamic contrast-enhanced scan, and to evaluate its application in the diagnosis of small hepatoceUular carcinomas. Methods Imaging data of 61 cases of small hepatocellular carcinomas obtained using a 3.0 T Siemens Magnetom Trio Tim magnetic resonance scanner for plain scan and multi-phase dynamic contrast-enhanced scans of three-dimen-sional volumetric interpolated breath-hold examination (3D-V1BE) were retrospectively analyzed with refer-ence to their pathological diagnoses. The signal and enhanced features and the detection rates of the tumors in different phases of examination were analyzed. Results Sixty-six lesions were detected in the rivers of the 61 patients by pathological examinations, of which 49 had pseudoeapsule formation, in their TI WI plain scanning, 43 (65.15%) lesions were found, of which pseudocapsules were found in 19 (38.78%). In their T2WI imaging, 53 (80.30%) lesions were found. In dynamic enhanced 3D-VIBE sequence, 65 (98.48%) lesions were found, of which 35 (71.43%) were found with pseudocapsules. The sizes of the carcinomas ranged from 0.8 to 3.0cm, 2. lcm on the average. The results of statistical analysis for the detection rates of the cancers of the three different sequences were significantly different (X2 = 24.197, P < 0.05). The differences of qualitative accu- racy obtained by plain scan (TIWI + T2WI) and 3D-VIBE sequence were significantly different (X2=66, P <0.05). Conclusion 3.0 T MRI 3D-VIBE sequence dynamic contrast-enhanced scan is high-speed and canclearly demonstrate the arterial phase, the portal venous phase and the parenchymal phase images. It not only can find small lesions which can not be found with a plain scan, but also can assist diagnosis through a time-intensity curve. It is of great value for detection and differential diagnosis of small hepatocellular carcinomas.