多期动态增强CT与MRI对小肝癌诊断的比较分析研究

发布时间：2018-11-24 16:19

【摘要】：目的评估慢性肝病合并小肝癌患者在多期动态增强CT及MRI扫描中强化程度的差异以及MRI双动脉期扫描的必要性。方法观察137例经病理证实的直径小于20mm的小肝癌病例。所有病例均行多期动态增强CT及MRI检查。比较病灶在CT及MRI动脉期强化程度和平衡期对比剂流出程度的差异,以及病灶在MRI动脉早期与动脉晚期强化程度的差异。相对于正常肝实质密度或信号,动脉期病灶明显强化评为1分,轻度强化为2分,无强化为3分;平衡期病灶密度或信号无减低(即无对比剂流出效应)为4分,轻度减低为5分,明显减低为6分。结果增强MRI动脉期小肝癌强化程度高于CT动脉期,CT平衡期小肝癌的对比剂流出效应优于MRI平衡期,组间比较差异均有统计学意义(P0.05)。在增强MRI双动脉期扫描中,动脉晚期小肝癌强化程度高于动脉早期,差异有统计学意义(P0.05)。近半数小肝癌(65/137,47.45%)在MRI平衡期出现边缘环状强化,明显高于CT平衡期(4/137,2.92%),差异有统计学意义(醊2=72.079,P0.05)。结论小肝癌在增强MRI动脉期强化效果优于CT,在MRI平衡期对比剂流出效应弱于CT,但MRI平衡期病灶的边缘环状强化可以辅助诊断。MRI双动脉期扫描,尤其是动脉晚期有助于提高小肝癌的检出。
[Abstract]:Objective to evaluate the degree of enhancement in multiphase dynamic enhanced CT and MRI in patients with chronic liver disease and small hepatocellular carcinoma and the necessity of MRI double arterial phase scan. Methods 137 cases of small liver cancer whose diameter was smaller than 20mm were observed. All cases were examined by multi-phase dynamic contrast enhanced CT and MRI. To compare the degree of enhancement and the efflux of contrast agent in CT and MRI, and to compare the degree of enhancement between early stage of MRI artery and late stage of MRI. Compared with the normal hepatic parenchyma density or signal, the enhancement of the lesions in arterial phase was evaluated as 1, 2 and 3 respectively. There was no decrease in the density or signal intensity (i.e. no contrast efflux effect) of the lesion in the equilibrium phase (4 points) and a slight decrease of 5 points (6 points). Results the enhancement degree of small hepatocellular carcinoma in MRI arterial phase was higher than that in CT artery phase, and the contrast agent efflux effect in CT equilibrium phase was better than that in MRI equilibrium phase, and there was significant difference between the two groups (P0.05). The enhancement degree of advanced small hepatocellular carcinoma in arterial stage was higher than that in early stage of artery in enhanced MRI double arterial phase scanning, the difference was statistically significant (P0.05). Nearly half of small hepatocellular carcinoma (65 / 137) (47.45%) showed circumferential enhancement in MRI equilibrium phase, which was significantly higher than that in CT (4 / 137) (2.92%). The difference was statistically significant (P 0.05). Conclusion the enhancement effect of small hepatocellular carcinoma in the arterial phase of MRI is better than that of the contrast agent outflow of CT, in the equilibrium phase of MRI, but the peripheral circular enhancement of the lesion in the equilibrium phase of MRI can assist in the diagnosis. MRI double arterial phase scan is helpful. Especially the late arterial stage is helpful to improve the detection of small liver cancer.
【作者单位】：首都医科大学附属北京佑安医院放射科;
【基金】：北京市医药管理临床医学发展专项经费资助(编号:ZYLX201511)
【分类号】：R735.7;R445.2;R730.44

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