摘要
目的探讨MRI连续动态增强扫描对肝细胞癌的价值,提高肝细胞癌诊断符合率。方法 39例经组织学或临床证实的肝细胞癌患者同时行CT平扫,多期增强扫描和MRI平扫,连续动态增强扫描。观察连续动态增强肿瘤表现出的强化模式;在连续动态增强扫描MRI,绘制肿瘤、主动脉、门静脉及肝组织的时间-信号强度曲线,并重建各期动态图像。对2种增强所表现的良、恶性特征进行分类、计数和比较。结果在39例肝细胞癌的连续动态增强扫描时间-信号强度曲线类型,速升速降型27例、速升平缓降(或台)型6例、缓升下降型5例、缓慢上升型1例;多期增强的强化模式,动脉期强化、门静脉期及延迟期密度(信号)减低20例;动脉期强化、门静脉期及延迟期密度(信号)不减低5例,动脉期不强化、门静脉及延迟期强化4例;动脉期不强化、门静脉期及延迟期密度(信号)低于肝组织10例。MRI连续动态增强扫描表现出的恶性征象明显高于多期动态扫描的强化模式(χ~2=37.375,P<0.000)。在肿瘤的综合诊断中,诊断等级定为肯定良性、可能良性、不能确定、可能肝细胞癌和肯定肝细胞癌,连续动态增强扫描等级例数相应为1、2、3、5、28;多期动态扫描分别为2、3、6、7、21,连续动态增强扫描的诊断符合率明显高于多期增强扫描(χ~2=49.259,P<0.000)。结论 MRI连续动态增强扫描能获得组织完整的对比剂流入和廓清状态,与多期增强比较,有利于对肿瘤个性化分析,对肝细胞癌诊断符合率高,具有推广价值。
Objective To evaluate diagnosing values of continuous MRI during enhancement to hepatocelllnlar carcinoma and promote diagnosing coincident rate. Methods 39 patients with hepatocellular carcinoma confirmed by histology or clinical were performed CT plain scan, multiple phase contrast enhanced scan and MRI plain scan, continuous dynamic enhanced scanning. Intensifying models of tumors in dynamic enhancement were observed. From continuous dynamic enhancement of MRI, time- signal intensity curves of tumor, aorta, portal vein and liver tissue were drawn and dynamic multi-imaging were reconstructed. Benign and malignant manifestations of both enhancing ways were classified, counted and compared. Results Types of time-signal intensity curves in continuous dynamic enhancement of MIKI were 27 rapidly ascend and rapidly descend, 6 rapidly ascend and slowly descend （plane）, 5 slowly ascend and descend, 1 slowly ascend. Model of multi-phase enhancing were 20 intensity in arterial phase, no intensity in portal and delay phase, 5 intensity in 3 phases, 4 no intensity in arterial phase, intensity in portal and delay phases, 10 no intensity in 3 phases. Continuous dynamic enhancing MRI showed more malignant characters of tumors than routine multi-phases CT enhancing （X2=37.375, P〈0.000）. Grade of minor were classified as affirmative benign, possible benign, uncertain possible malignant, affirmative malignant by synthetic diagmosis. Accordingly, nnmber of cases in continuous dynamic enhancing MRI ordinally were 1, 2, 3, 5, 28 and nnmber of cases in multi-phase enhancing MRI ordinally were 2, 3, 6, 7, 21. Continuous dynanfic enhancing MRI had higher diagnosing coincident rate than multi-phase enhancing CT（ X2=49.259, P〈0.000）. Conclusion Continuous dynamic enhancing MRI could shows full intensifying process of contrast medium. Compared with multi-phase enhancement, It is able to analyse severally tumor and promote diagnosing coincident rate of hepatocellular carcinoma. So continuous dynanfic enhancing MRI is a way of deserving generalization.
出处
《中国CT和MRI杂志》
2017年第5期92-95,111,共5页
Chinese Journal of CT and MRI
关键词
MRI
连续动态增强
CT
多期增强
肝细胞癌
MRI
Continuous Dynamic Enhancing
CT
Multi-phase Enhancement
Hepatocellular Carcinoma
