AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS...AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS:Twenty-two patients with 24 HCC lesionsconfirmed by biopsy or surgical resection underwentMR imaging in 4-9wks after TACE with a superconducting1.5 T MR scanner, including SE T1WI, T2WI and FMPSPGRdynamic contrast scanning. The signal intensities of alllesions on SE T1WI, T2WI and the enhancement patternson FMPSPGR dynamic contrast scanning were observed,and the comparison was made between MRI findingsand pathological results in ail the cases.RESULTS:Of the 24 lesions, the signal intensities werevarious on SE T1WI and T2WI. On T1WI, 13 lesionsappeared as hyperintense, 4 lesions were isointenseand the other 7 lesions were hypointensese.Histologically, hyperintense lesions showed on T1WIwere viable tumor or hemorrhage; isointensities werecoagulative necrosis or inflammatory infiltration;hypointensities were tumor, liquified necrosis,coagulative necrosis or inflammatory infiltration. OnT2WI, 15 lesions appeared as hyperintense, 3 lesionswere isointense and the other 6 lesions werehypointensese. Hyperintense lesions showed on T2WIwere residuals of viable tumor, hemorrhage, liquefiednecrosis or inflammatory infiltration; isointense lesionswere residuals of viable tumor or inflammatoryinfiltration; hypointense lesions were coagulativenecrosis. On FMPSPGR dynamic contrast scanning, 18of the 24 lesions enhanced on early-phase dynamicscanning conesponding to residuals of viable tumor andthe other 6 lesions had no enhancement at this phasebecause complete necrosis were seen in the histologicexamination. On delayed-phase dynamic scanning, 6lesions had permanent enhancement appeared asinhomogeneous hyperintensity and both residuals ofviable tumor and inflammatory infiltration were foundby histologic examination. 18 lesions were hypointenseat this phase and 8 of them coexisted with peripheralring-like enhancement of the lesions resulting fromviable tumors or inflammatory infiltration.CONCLUSION: FMPSPGR MR dynamic contrast scanningcan reflect the pathologic changes of HCC treated byTACE. Especially, early-phase dynamic scanning canevaluate accurately residuals of viable tumor andnecrosis in HCC lesions. FMPSPGR dynamic contrastscanning is useful in the follow-up of patients with HCCtreated by TACE combined with SE T1WI and T2WI, butit is difficult to differentiate peripheral viable tumorsfrom inflammatory infiltration.展开更多
基金Clinical Important Item of Chinese Health Ministry,No.97030220
文摘AIM:To evaluate the role and limitation of fast multiplanarspoiled gradient-recalled (FMPSPGR) MR dynamiccontrast scanning in the follow-up of patients with HCCtreated by transarterial chemoembolization (TACE).METHODS:Twenty-two patients with 24 HCC lesionsconfirmed by biopsy or surgical resection underwentMR imaging in 4-9wks after TACE with a superconducting1.5 T MR scanner, including SE T1WI, T2WI and FMPSPGRdynamic contrast scanning. The signal intensities of alllesions on SE T1WI, T2WI and the enhancement patternson FMPSPGR dynamic contrast scanning were observed,and the comparison was made between MRI findingsand pathological results in ail the cases.RESULTS:Of the 24 lesions, the signal intensities werevarious on SE T1WI and T2WI. On T1WI, 13 lesionsappeared as hyperintense, 4 lesions were isointenseand the other 7 lesions were hypointensese.Histologically, hyperintense lesions showed on T1WIwere viable tumor or hemorrhage; isointensities werecoagulative necrosis or inflammatory infiltration;hypointensities were tumor, liquified necrosis,coagulative necrosis or inflammatory infiltration. OnT2WI, 15 lesions appeared as hyperintense, 3 lesionswere isointense and the other 6 lesions werehypointensese. Hyperintense lesions showed on T2WIwere residuals of viable tumor, hemorrhage, liquefiednecrosis or inflammatory infiltration; isointense lesionswere residuals of viable tumor or inflammatoryinfiltration; hypointense lesions were coagulativenecrosis. On FMPSPGR dynamic contrast scanning, 18of the 24 lesions enhanced on early-phase dynamicscanning conesponding to residuals of viable tumor andthe other 6 lesions had no enhancement at this phasebecause complete necrosis were seen in the histologicexamination. On delayed-phase dynamic scanning, 6lesions had permanent enhancement appeared asinhomogeneous hyperintensity and both residuals ofviable tumor and inflammatory infiltration were foundby histologic examination. 18 lesions were hypointenseat this phase and 8 of them coexisted with peripheralring-like enhancement of the lesions resulting fromviable tumors or inflammatory infiltration.CONCLUSION: FMPSPGR MR dynamic contrast scanningcan reflect the pathologic changes of HCC treated byTACE. Especially, early-phase dynamic scanning canevaluate accurately residuals of viable tumor andnecrosis in HCC lesions. FMPSPGR dynamic contrastscanning is useful in the follow-up of patients with HCCtreated by TACE combined with SE T1WI and T2WI, butit is difficult to differentiate peripheral viable tumorsfrom inflammatory infiltration.
