【摘要】 目的对比3.0T MRI增强扫描及多期增强多排螺旋CT(multi detector row computed tomographic,MDCT)对肝硬化患者合并小肝癌(small hepatocellular carcinoma,SHCC)的诊断价值,评估MRI快速容积扫描(LAVA)序列的优势。方法观察19例经病理证实的28个SHCC在CT及MRI检查中的检出率、强化方式、假包膜、"镶嵌征"等特点,与病理结果进行对照。CT阅片1次完成;MRI阅片分2组进行,组1(MRI1)包括T1WI、T2WI、DWI、同反相位、LAVA序列在内的所有图像,组2(MRI2)仅包括LAVA序列。对CT与MRI1、CT与MRI2的诊断结果进行评估。结果 19例患者共检出28个SHCC,检出率:CT 78.6%(22个病灶),MRI 100%(28个病灶)。具有典型强化模式(动脉期强化,门脉期或平衡期廓清)病灶:CT 10个,MRI 15个;"镶嵌征"CT 8个,MRI 5个;假包膜CT 10个,MRI 20个。MRI1与CT、MRI2与CT诊断结果比较,差异均有统计学意义(P<0.05)。结论 MRI与CT比较,在SHCC检出方面有明显优势,肝细胞特异性对比剂钆钡葡胺(Gd-BOPTA)的应用进一步增加了LAVA序列对SHCC的检出率。更多还原

【Abstract】 Objective To investigate the diagnostic value of Gd-BOPTA enhanced MRI(3.0 T) and multiphasic multirow detector CT(MDCT) in detecting small hepatocellular carcinoma(SHCC).Methods A total of 19 patients with hepatocellular carcinomas(HCCS)who were confirmed by the pathological examination results were enrolled in the study.The detection rate,enhancement mode, characteristics of pseudocapsule and mosaic pattern were observed and compared with the pathological examination results.The evaluation of CT images was completed at one time.The evaluation results of all MRI sequences were defined as MRI1,while the results of only LAVA sequence were defined as MRI2.The results of CT were compared with those of MRI1 and MRI2,respectively.The diagnostic efficiency of these techniques in detecting HCC was assessed.Results A total of 28 SHCC lesions were detected in 19 patients,with the detection rate being 78.6%(22 lesions) by CT and 100%(28 lesions) by MRI.Moreover there were 10 typical lesions with the typical enhancement patterns by enhanced CT images and 15 lesions by MRI,and there were 8 typical mosaicism signs by CT and there were 5 typical mosaicism signs by MRI,moreover,there were 10 pseudocapsule lesions by CT and 20 pseudocapsule lesions by MRI.There were significant differences in the diagnostic results between MRI1 and CT,between MRI2 and CT(P<0.05).Conclusion As compared with CT,MRI has obvious advantages in detection of SHCC.The application of Gd-BOPTA can improve the detection rate of SHCC by LAVA sequence更多还原