摘要
目的探讨肝脏局灶性病变(FHL)的强化方式在其定性诊断中的价值。方法前瞻性纳入47例FHL病例(50个病灶),采用MRI三维容积式内插值法屏气检查序列(3D-VIBE)对病灶进行包括动脉早期、动脉晚期和门静脉期在内的多期动态增强扫描,分析3D-VIBE序列所显示的病灶形态学特点和测量病灶的对比噪声比,重点观察病灶的强化方式和强化方式的动态演变过程。结果①17例(20个病灶)肝细胞肝癌(HCC)多表现为“动脉期快进、门静脉期快出”的强化方式,60%的HCC出现“假包膜”,65%合并肝硬变背景;②3例胆管细胞肝癌动脉期轻度强化,门静脉期及延迟期强化,67%合并有病灶周围近侧肝内胆管的扩张;③12个(100%)转移性肝癌均表现为周边程度不一的环形强化;④肝血管瘤在动脉早期边缘呈周边结节样强化,并随时间推移出现向心性的“推进式”强化;⑤4例细菌性肝脓肿主要表现为脓肿壁的簇状或环形强化和内部纤维分隔的轻度强化,1例嗜酸性肉芽肿仅轻度强化。结论FHL的形态学特征以及动脉期的强化特点和强化演变方式对定性诊断帮助较大;MRI3D-VIBE序列多期动态扫描是提供上述信息的最优影像学技术。
Objective To investigate the diagnostic value of the enhancement patterns for characterizing various focal hepatic lesions （FHL）. Methods Forty-seven patients （50 lesions） were included into the study. The morphologic features and the dynamic enhancement patterns of FHL were observed in the early arterial phase, late arterial phase and portal venous phase. The degree of FHL enhancement was analyzed by calculating the contrast-to-noise ratio. Results 70% of the HCCs presented ＂fast-filling and rapid-washout＂ feature; 67% of the cholangiocarcinomas showed slight enhancement in arterial phase, and 33.3% had delayed enhancement on portal venous phase; All hemangiomas presented peripheral nodular enhancement in arterial phase, which then demonstrating centropedal ＂push-on＂ enhancement in portal venous phase; Hepatic abscesses mainly presented a slightly enhanced rim around the lesion with fibrous septa inside and an edematous zone outside. Conclusion The enhancement pattern and the dynamic evolution of FHL enhancement had a great diagnostic value for different FHL by using MRI 3D-VIBE sequence.
出处
《中国普外基础与临床杂志》
CAS
2006年第4期474-478,共5页
Chinese Journal of Bases and Clinics In General Surgery
