摘要
目的采用改良MRI灌注半定量方法评估肝脏局灶性病变各参数特点及探讨对病变定性的价值。方法应用三维容积式内插技术MRI对70例行不间断扫描,连续采集50期全肝数据,同步经静脉注入对比剂,根据灌注的时间-信号曲线,获得病变的最大信号强度、达峰时间、强化坡度及早期、后期对比剂下降坡度,并进行统计学分析。结果最高信号强度,血管瘤和局灶性结节增生分别为019.01±410.29和916.96±174.28,高于肝细胞癌、转移瘤和肝脓肿(分别为722.47±192.78、744.25±167.42和733.45±242.72)。达峰时间(单位:s),肝细胞癌和转移癌分别为24.49±11.09和31.58±6.96,短于血管瘤和肝脓肿(分别为59.14±20.13和59.63±2.36)。局灶性结节增生为18.55±8.16,达峰时间最短。增强坡度(单位为信号强度/s),肝细胞癌为37.63±30.08,高于转移瘤(为24.90±8.63),两者均高于血管瘤和肝脓肿(分别为59.25±28.82和2.68±4.77)。局灶性结节增生为59.25±28.82,明显高于其他良恶性病变。早期下降坡度和后期下降坡度(单位为信号强度/s),肝细胞癌分别为13.01±22.71和13.01±22.71,肝脓肿分别为16.98±22.26和0.20±0.21,两者高于其他病变。以上数据经方差分析,具有显著性差异(P<0.05)。结论本组数据提示肝脏恶性病变与良性病变具有差异,但局灶性结节增生具有特殊性,应结合形态学改变进行鉴别。应用改良MRI灌注半定量方法分析肝脏局灶性病变,使病变的增强表现准确地参数化,是诊断与鉴别诊断有价值的方法。
Objective To evaluate the perfusion parameters of liver local focus and the values in differential diagnosis using improved perfusion MRI . Methods 3D volumetric interpolated MRI performed in 70 patients. Fifty phases images of whole liver were obtained by continual scan and contrast agent administration simultaneously. The time-signal curves, maximum value of the signal intensity, time to peak, wash-in slope, early wash-out slope and late wash-out slope were measured. Results For maximum value of the signal intensity, hemangioma and focal nadular hyperplasia were 019.01 ± 410.29 and 916.96 ±174.28 respectively and higher than hepatocellular carcinoma and metastases （722.47 ± 192.78, 744.25 ± 167.42 and 733.45 ± 242.72 ）. For time to peak （ unit ： s） , hepatocellular carcinoma and metastases were 24.49 ± 11.09 and 31.58 ± 6.96 respectively and shorter than hemangioma and liver abscess （59.14 ± 20.13 and 59.63 ± 2.36 ）. Focal nadular hyperplasia had the shortest （18.55 ±8.16） time to peak in all the diseases. For wash in slope （unit： signal intensity/s） , hepatocellular carcinomas were 37.63 ± 30.08 , which was higher than metastases （24.90 ±8.63 ）. But the both malignant tumors were higher than hemangioma and liver abscess （ 59.25 ± 28.82 and 2.68 ± 4.77 ）. Focal nadular hyperplasia was 59.25 ± 28.82 and was the highest wash in slope in all diseases. For early wash out slope and late wash out slope （ unit ： signal intensity/s）, hepatocellular carcinoma were 13.01 ± 22.71 and 13.01 ± 22.71 respectively, liver abscess were 16.98 ± 22.26 and 0.20 ± 0.21 respectively. Conclusion Parameters of malignant tumors were different with benign diseases. But parameters of focal nodular hyperplasia had particularity so that the imaging manifestations need to be considered in making diagnosis. Semi-quantitative analysis of improved perfusion MRI could quantified contrastenhancing manifestations, which had value in diagnosis and differentiating diagnosis.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第6期872-875,共4页
Journal of Clinical Radiology
