肝硬化结节及小肝癌患者3.0T MRI检查结果分析

目的评价3.0 T MRI检查在肝硬化再生性结节（RN）、异型增生性结节（DN）和小肝癌（SHCC）诊断和鉴别诊断中价值。方法回顾性分析经病理检查确诊的69例RN、DN及SHCC患者的3.0 T MRI平扫及容积采集技术（LAVA）三期动态增强扫描特点。结果 RN主要表现为T2WI低信号,动态增强方式呈＂缓慢上升型＂;DN主要表现为T2WI高、低信号,信号较均匀结节的动态方式以＂速升缓降型＂为主,可有＂结中结＂（特征表现）;SHCC主要表现为T1WI低信号、T2WI高信号,动态增强方式为＂速升速降型＂。结论肝硬化结节及小肝癌在3.0 T MRI上各有较为典型的表现,临床可据此进行诊断与鉴别诊断;对其他强化类型的肝脏病灶应结合肿瘤血管的扭曲增粗及包膜等表现排除SHCC。

Analsis of 3.0 T MRI examinations of hepatocirrhosic nodules and small hepatocellular carcinoma

Objective To investigate the value of 3.0 T MRI examinations in the diagnosis and differential diagnosis of regeneraive nodules（RN）,dysplastic nodules（DN） and small hepatocellular carcinoma（SHCC）.Methods The features of 3.0 T MRI plain scan and liver acceleration volume acquis（LAVA）three-phased dynamic enhanced scan in 69 patients confirmed pathologically RN,DN and SHCC were analyzed.Results The main findings of RN nodules were hypointensity on T2WI.The dynamic enhanced scan showed the type of rise slightly;the main findings of DN nodules were hypointensity on TlWI and hyperintense on T2WI,the dynamic enhanced scan showed the type of rapid rising initially and decreasing slowly,the characteristic sign was＂nodule in nodule＂;SHCC mainly showed hypointensity on T1WI and hyperintense on T2WI,the dynamic enhanced scan showed the type of rapid rising initial and rapid declining.Conclusions 3.0T MRI has very important clinical value in the diagnosis and differential diagnosis of hepatic RN,DN and SHCC which has their typical features.It can exclude SHCC according to the sign of confusiontumor vessel and pseudocapsule for the liver lesions with other types of enhanced scan.