微小肝癌1.5/3.0 T MR不同序列信号演变
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摘要
目的回顾性分析微小肝癌(MHCC)1.5/3.0T MR平扫信号及强化表现的演变规律,为MHCC的早期诊断提供依据。方法搜集整理肝癌治疗后复发及慢性肝病背景定期MRI复查发现、病理及临床诊断的MHCC患者共140例(152个癌灶),比较每次复查平扫各序列信号及动态增强表现,总结其信号演变规律。结果纳入统计的100例(112个癌灶)MHCC中, DWI高信号病灶数所占比例为91.0%(106/112);T_2WI高信号占83.0%(93/112);T_1WI低信号占78.6%(88/112);可以观察到动脉期异常强化早于平扫各序列信号改变的16例。未纳入统计的另40例均为前瞻性搜集有类似"强化早于信号表现"的病例。结论典型MHCC演变过程中,平扫序列出现异常信号表现的敏感性及先后次序为DWI、T_2WI、T_1WI,而动脉期异常强化可早于平扫信号改变。
Objective To retrospectively analyze the evolution of 1.5/3.0 T MR scan signal and enhanced performance of micro-small hepatocellular carcinomas(MHCC), and provide evidence for early diagnosis of MHCC. Methods A total of 140 cases(152 cancers) of microscopic liver cancer patients with recurrence and chronic liver disease after recurrence and chronic liver disease were collected. The results of each review were compared with each other and the dynamic enhancement performance was summarized. Evolution. Results In 100 cases(112 cancers) of MHCC, the proportion of DWI high signal lesions was 91.0%(106/112); T_2WI high signal accounted for 83.0%(93/112); T_1WI low signal accounted for 78.6%.(88/112); 16 cases with abnormal enhancement of arterial phase earlier than those of each sequence were observed. The other 40 patients who were not included in the statistics were prospectively recruited for cases with similar enhancements earlier than signal performance. Conclusion During the evolution of typical MHCC, the sensitivity and order of abnormal signal expression in the plain scan sequence are DWI, T_2WI, T_1WI, and the abnormal enhancement of arterial phase can be changed earlier than the plain signal.
Objective To retrospectively analyze the evolution of 1.5/3.0 T MR scan signal and enhanced performance of micro-small hepatocellular carcinomas(MHCC), and provide evidence for early diagnosis of MHCC. Methods A total of 140 cases(152 cancers) of microscopic liver cancer patients with recurrence and chronic liver disease after recurrence and chronic liver disease were collected. The results of each review were compared with each other and the dynamic enhancement performance was summarized. Evolution. Results In 100 cases(112 cancers) of MHCC, the proportion of DWI high signal lesions was 91.0%(106/112); T_2WI high signal accounted for 83.0%(93/112); T_1WI low signal accounted for 78.6%.(88/112); 16 cases with abnormal enhancement of arterial phase earlier than those of each sequence were observed. The other 40 patients who were not included in the statistics were prospectively recruited for cases with similar enhancements earlier than signal performance. Conclusion During the evolution of typical MHCC, the sensitivity and order of abnormal signal expression in the plain scan sequence are DWI, T_2WI, T_1WI, and the abnormal enhancement of arterial phase can be changed earlier than the plain signal.
引文
1 张见增,胡海东,尤金涛,等.微小肝癌的MRI的表现及诊断[J]. 临床放射杂志,2017,36:88-92.
2 杨正汉,冯逢,王霄英.磁共振成像技术指南-检查规范、临床策略及新技术应用[M]. 第1版.北京:人民军医出版社,2007,375-376.
3 程红岩,贾雨辰,王培军,陈克敏.肝胆疾病影像学[M].第1版.上海:上海科学技术出版社,2005:277-283.
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6 徐鹏举,严福华,王建华,等.弥散加权成像对肝细胞癌小病灶检测的价值[J].中华医学杂志,2009,89:592-596.
7 Xu PJ,Yan FH,Wang JH,et al. Added value of breathhold diffusion-weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast-enhanced MRI alone using receiver operating characteristic curve analysis [J].J Magn Reson Imaging,2009,29:341-349.
8 中国抗癌协会肝癌专业委员会,中华医学会肝病学分会肝癌学组,中国抗癌协会病理专业委员会,等.原发性肝癌规范化病理诊断指南(2015年版).中华肝胆外科杂志,2015,21:145-151.
9 中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版) [J].临床肝胆病杂志,2011,27:1141-1159.
2 杨正汉,冯逢,王霄英.磁共振成像技术指南-检查规范、临床策略及新技术应用[M]. 第1版.北京:人民军医出版社,2007,375-376.
3 程红岩,贾雨辰,王培军,陈克敏.肝胆疾病影像学[M].第1版.上海:上海科学技术出版社,2005:277-283.
4 Muhi A,Ichikawa T,Motosugi U,et al. High-b-value diffusion weighted MR imaging of hepatocellular lesions:estimation of grade of malignancy of hepatocellular carcinoma [J].J Magn Reson Imaging,2009,30:1005-1011.
5 Nasu K,Kuroki Y,Tsukamoto T,et al. Diffusion-weighted imaging of surgically resected hepatocellular carcinoma:imaging characteristics and relationship among signal intensity,apparent diffusion coefficient,and histopathologic grade [J]. AJR,2009,193:438-444.
6 徐鹏举,严福华,王建华,等.弥散加权成像对肝细胞癌小病灶检测的价值[J].中华医学杂志,2009,89:592-596.
7 Xu PJ,Yan FH,Wang JH,et al. Added value of breathhold diffusion-weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast-enhanced MRI alone using receiver operating characteristic curve analysis [J].J Magn Reson Imaging,2009,29:341-349.
8 中国抗癌协会肝癌专业委员会,中华医学会肝病学分会肝癌学组,中国抗癌协会病理专业委员会,等.原发性肝癌规范化病理诊断指南(2015年版).中华肝胆外科杂志,2015,21:145-151.
9 中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版) [J].临床肝胆病杂志,2011,27:1141-1159.