肝胆特异性磁共振对比剂Gd-EOB-DTPA在肝脏局灶性结节增生的诊断价值

发布时间：2018-05-09 14:14

本文选题：钆塞酸二钠 + 肝脏局灶性结节增生　；参考：《中国医学计算机成像杂志》2017年05期

【摘要】：目的:探讨使用Gd-EOB-DTPA增强MRI在肝脏局灶性结节增生(FNH)的诊断价值。方法:进行回顾性分析16例经病理证实的FNH的MRI检查资料,所有病例均行MRI平扫及Gd-EOB-DTPA增强扫描。结果:16例共20个病灶,位于肝左叶8个,肝右叶6个,尾状叶2个,跨叶生长4个。MRI特征T1WI 9例呈等信号,7例呈稍低信号,抑脂T2WI 6例呈等信号,10例呈稍高信号;7例病灶见中央瘢痕,呈T1WI低信号,T2WI高信号。动态增强动脉期16例病灶均明显强化;门脉期持续强化,12例呈稍高信号,4例呈等信号;平衡期11例呈等信号,5例呈稍高信号;肝细胞特异期,7例病灶以等信号为主,9例呈不均匀稍高及等、低混杂信号。中央瘢痕动脉期无强化,门脉期及平衡期持续延迟强化,肝细胞特异期呈低信号。结论:使用Gd-EOB-DTPA增强MRI诊断FNH具有很高的敏感性及特异性,FNH对Gd-EOB-DTPA特异性摄取而呈等、高信号,Gd-EOB-DTPA增强能准确地显示FNH的血供特点及病理特征,大大提高与肝内其他病变的鉴别诊断能力。
[Abstract]:Objective: to evaluate the diagnostic value of Gd-EOB-DTPA enhanced MRI in focal nodular hyperplasia of liver. Methods: the MRI findings of 16 cases of pathologically proved FNH were retrospectively analyzed. All cases underwent MRI plain scan and Gd-EOB-DTPA enhanced scan. Results there were 20 lesions in 16 cases, including 8 lesions in Zuo Ye, 6 in right lobe, 2 in caudate lobe, and 4 in translobar growth. MRI features of 9 cases showed isokinetic signal intensity in 7 cases and slightly low signal intensity in 7 cases. In 6 cases of lipid-suppressive T2WI, 10 cases showed iso-signal intensity and 10 cases showed slightly hyperintense lesions, 7 cases showed central scar, and showed T1WI low signal intensity on T _ 2WI. In dynamic contrast enhanced arterial phase, 16 lesions were obviously enhanced, 12 cases showed slight hyperintense signal in 12 cases, 11 cases showed isointense signal in 5 cases in equilibrium phase, 12 cases showed slight hyperintense signal in 12 cases, and 5 cases showed slight hyperintense signal in 11 cases in equilibrium phase. In 7 cases of hepatocyte specific phase, iso-signal was the main signal in 9 cases, which showed heterogeneity and homogeneity and low mixed signal. There was no enhancement in the arterial phase of central scar, but delayed enhancement in portal phase and equilibrium phase, and low signal intensity in the specific phase of hepatocyte. Conclusion: Gd-EOB-DTPA enhanced MRI has high sensitivity and specificity in the diagnosis of FNH. Gd-EOB-DTPA enhancement can accurately display the blood supply characteristics and pathological features of FNH. To improve the ability of differential diagnosis with other liver diseases.
【作者单位】：郑州市人民医院影像科;安阳市人民医院影像科;
【分类号】：R445.2;R575

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