【摘要】 目的观察慢性乙型肝炎(CHB)后肝硬化结节MRI特征及其在纵向随访中的影像学变化与转归。方法回顾性分析80例CHB后肝硬化患者2次以上腹部MRI,根据首次MRI诊断结果分为肝再生结节(HRN)组(n=68)及肝细胞异型增生结节(HDN)组(n=12),分析其特征改变及进展为肝细胞癌(HCC)情况。结果 2组患者性别及年龄差异均无统计学意义(P均>0.05)。HRN组中位随访时间为40.5个月,恶变率32.35%(22/68);HDN组中位随访时间39.0个月,恶变率为16.67%(2/12)。首次MR显示HRN组67例T1WI呈等信号、1例呈高信号,T2WI、DWI、动脉期及延迟期增强均呈等信号;HDN组T1WI 9例呈等信号、3例呈高信号,T2WI显示10例呈等信号、2例呈高信号;DWI均呈等信号;动脉期4例呈等信号,8例呈高信号,延迟期10例呈等信号,2例呈低信号。随访结束时24例恶变,T1WI示21例呈低信号、3例呈等信号,T2WI、DWI均呈高信号,增强MR动脉期20例呈高信号、4例呈等信号,延迟期23例呈低信号、1例呈等信号。结论肝硬化结节转归具有多样性,增强MR动脉期强化程度增加、延迟期强化程度减退、T2WI及DWI信号逐渐增高可提示其恶变。更多还原

【Abstract】 Objective To observe MRI features of cirrhosis nodules after chronic hepatitis B(CHB) as well as imaging changes and outcomes during longitudinal follow-up. Methods Data of more than 2 times abdominal MRI of 80 patients with cirrhosis after CHB were retrospectively analyzed. According to the first MRI diagnosis, the patients were divided into hepatic regenerative nodule(HRN) group(n=68) and hepatocellular dysplasia nodule(HDN) group(n=12), the characteristic changes and progression to hepatocellular carcinoma(HCC) were observed. Results There was no significant difference of gender nor age between 2 groups(both P>0.05). The median follow-up time of HRN group was 40.5 months, of HDN group was 39.0 months. The malignant transformation rate of HRN group was 32.35%(22/68), of HDN group was 16.67%(2/12). The first MR T1 WI showed iso signals in 67 cases and hyper signal in 1 case of HRN group, while T2 WI, DWI, arterial phase and delayed phase enhanced MRI showed iso signals in all 68 cases. In HDN group, T1 WI showed iso signals in 9 cases and hyper signals in 3 cases, T2 WI showed iso signals in 10 cases and hyper signals in 2 cases, DWI showed iso signals in all 12 cases, while arterial phase enhanced MRI showed iso signals in 4 cases and hyper signals in 8 cases, delayed phase enhanced MRI showed iso signals in 10 cases and hypo signals in 2 cases. At the end of follow-up, HCC were detected in 24 cases. T1 WI showed hypo signals in 21 cases and iso signals in 3 cases of HCC, T2 WI and DWI showed hyper signals in all 24 cases. Arterial phase enhanced MRI showed hyper signals in 20 cases and iso signals in 4 cases, delayed phase enhanced MRI showed hypo signals in 23 cases and iso signal in 1 case. Conclusion The prognosis of liver cirrhosis nodules was diverse. Increased enhancement in arterial phase, decreased enhancement in delayed phase and gradually increased T2 WI and DWI signals suggested malignant transformation of cirrhosis nodules.更多还原