摘要
背景与目的:肝硬化结节癌变是肝硬化转变成为肝癌的必经阶段,早期发现和早期干预对提高患者的生存率具有重要意义。本研究探讨联合应用MRI、DSA和碘油CT对肝硬化结节癌变诊断价值,旨在早期发现肝硬化结节癌变。方法:收集经病理证实的肝硬化癌变病例18例,所有患者均行MRI、DSA和和碘油CT检查,分析MRI、DSA和碘油CT对肝硬化结节恶变的诊断价值。结果:18例患者中共有31个病灶,其中MRI发现病灶29个,肿瘤病灶T1WI呈低信号12个,高信号9个,等信号8个;T2WI呈稍高信号20个,等信号9个;DWI呈高信号23个;三期动态增强扫描呈"快进快出"共18个,"快进慢出"3个,持续强化3个;另有5个病灶因T1WI呈高信号,强化表现观察不满意。DSA发现27个病灶,表现为肿瘤血管生成、血管扭曲、血供增多、肿瘤染色;2周后复查碘油CT,31个病灶均有碘油沉积。结论:MRI、DSA和碘油CT联合应用能提高肝硬化结节癌变的诊断准确性,从而早期发现肝硬化结节癌变。
Background and purpose: Hepatocellular carcinoma with dysplastic nodule in liver cirrhosis is the necessary stage of liver cirrhosis into hepatocellular carcinoma. Early detection and early intervention has important significance. Our study was to explore the value of MRI, DSA and lipiodol CT in the diagnosis of hepatocellular carcinoma with dysplastic nodule in liver cirrhosis, and to improve the early diagnosis. Methods: Medical images of 18 liver cirrhosis patients with 31 lesions with pathologically proved were collected and all examined with MRI, DSA and lipiodol CT. Results: Among the 29 lessions detected by MRI, 12 lesions showed as hypointense, 9 lesions showed as hyperintense, 8 lesions showed as isointense on T1WI. Twenty lesions showed as hyperintense on T2WI. Among the 25 lessions showed on DWI, 18 lessions showed early enhancement in artery phase, "fast in fast out" in portal venous phases, 3 of"fast in and slow out" sign. DSA showed tumor staining in 27 eases including hypervascular supply from hepatic artery to tumor. After two weeks, 31 lessions were detected with lipiodol CT. Conclusion: The combined using of MRI, DSA and lipiodol CT will be helpful in the diagnosis of hepatocellular carcinoma with dysplastic nodule in liver cirrhosis.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2012年第5期377-380,共4页
China Oncology
关键词
磁共振成像
血管造影
碘油CT
肝硬化结节
癌变
Magnetic resonance imaging
DSA
Lipiodol CT
Regenerative nodules
Carcinogenesis