高场强MRI LAVA增强联合DWI对肝硬化背景上小肝癌的诊断价值

发布时间：2018-05-12 07:54

本文选题：小肝癌 + 肝脏加速容积采集技术　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：目的探讨3.0T MR肝脏加速容积采集技术联合DWI对肝硬化背景上小肝癌检出与定性的价值。方法收集经病理、DSA介入证实的107例肝硬化背景上的小肝癌患者的影像资料。共发现病灶119个，单发病灶95个，两个病灶的12例，所有小肝癌患者均行T1WI（正、反相位），T2WI，多期动态增强扫描（LAVA序列），，DWI扫描（b值800s/mm2）。比较并分析T1WI、T2WI、DWI、 LAVA增强各期及LAVA增强联合DWI与LAVA增强对小肝癌的检出率；T1WI（正、反相位）、T2WI、LAVA增强（Ａ组），T1WI（正、反相位）、T2WI、DWI（Ｂ组），二者联合（Ｃ组）在小肝癌定性方面的价值。观察各序列上小肝癌的信号特点，比较并分析各序列对小肝癌包膜的显示，绘制病灶及周围肝组织的时间信号强度曲线，测量小肝癌及其周围肝组织ADC值。结果1、LAVA增强检出小肝癌较DWI，T2WI，T1WI高，但LAVA增强与DWI比较无统计学差异。2、LAVA动脉期检出小肝癌较门脉期或平衡期高，且具有统计学差异。3、LAVA增强显示小肝癌包膜（数量及完整性）多于于T1WI、T2WI，其中T1WI又多于T2WI。4、LAVA增强联合DWI较单独使用LAVA增强检出微小肝癌高，但两者之间无明显统计学差异。5、C组准确定性小肝癌较A组、B组高，且具有统计学差异。6、小肝癌ADC值低于周围肝组织，二者之间比较具有统计学差异。结论1、LAVA增强较DWI、T2WI、T1WI可以较好的检出小肝癌。2、LAVA多期增强动脉期对肝硬化背景上小肝癌的检出非常重要。3、LAVA增强（门脉期+平衡期）显示小肝癌的包膜（数量、完整性）优于T1WI、T2WI，其中T1WI优于T2WI。4、LAVA增强联合DWI可以减少对微小肝癌的漏诊，DWI是LAVA增强有益的补充。5、LAVA增强联合DWI有利于提高肝硬化背景上小肝癌的定性。6、本研究小肝癌ADC值低于周围肝组织，说明小肝癌弥散受限。
[Abstract]:Objective to investigate the value of 3.0T Mr liver accelerated volume acquisition combined with DWI in the detection and characterization of small hepatocellular carcinoma (HCC) in the background of liver cirrhosis. Methods the imaging data of 107 patients with small liver cancer confirmed by DSA were collected. A total of 119 lesions, 95 single lesions and 12 cases of two lesions were found. All patients with small liver cancer were treated with T1WI (positive, inverse phase T2WI). To compare and analyze the positive rate of T1WI, T2WII DWI, LAVA enhancement combined with DWI and LAVA enhancement in small hepatocellular carcinoma (SHCC) and the value of T1WI (positive, reverse phase T2WILVA enhanced group A) T1WI (positive, negative phase T2WIDWIIB group) in the qualitative aspect of small hepatocellular carcinoma (SHCC). The signal characteristics of small hepatocellular carcinoma (HCC) on each sequence were observed and compared and analyzed. The time signal intensity curves of focus and surrounding liver tissue were plotted and the ADC values of small liver cancer and its surrounding liver tissue were measured. Results (1) the detection of small hepatocellular carcinoma was higher than that of DWI T2WIT T1WI, but there was no significant difference between LAVA enhancement and DWI. 2 the small HCC detected in arterial phase was higher than that in portal phase or equilibrium phase. The number and integrity of the capsule of small hepatocellular carcinoma was more than that of T1WIV T2WI, and T1WI was higher than that of T2WI.4Laiva combined with DWI, compared with that of LAVA alone. But there was no statistical difference between the two groups. The accurate characterization of small hepatocellular carcinoma in group C was higher than that in group A and B, and there was a statistical difference. The ADC value of small liver cancer was lower than that of surrounding liver tissue, and there was a statistical difference between the two groups. Conclusion (1) compared with DWI-T2WII-T _ 1WI, LAVA can be used to detect small hepatocellular carcinoma (SHC) in arterial phase. It is very important to detect SHCC in the background of cirrhosis. 3% LAVA enhancement (balance phase of portal vein) shows the number of small hepatocellular carcinoma (SHCC). T1WI is better than T2WI.4L LAVA combined with DWI can reduce the missed diagnosis of small hepatocellular carcinoma. It is a useful supplement of LAVA enhancement. 5% LAVA enhancement combined with DWI is helpful to improve the quality of small liver cancer in liver cirrhosis background. This study is to study small hepatocellular carcinoma. The ADC value was lower than that in the surrounding liver tissue. This indicates that the diffusion of small hepatocellular carcinoma is limited.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R735.7;R445.2

【参考文献】