人工手推法gddtpa动态增强对小肝癌的mri诊断.docVIP

人工手推法GdDTPA动态增强对小肝癌的MRI诊断 nbsp;nbsp;nbsp; 作者;田旭玉，陈建波，张暹东，李茂林，王丽凤，兰 岚 ［摘要］nbsp; 目的nbsp; 探讨人工手推注射法Gd-DTPA动态增强MRI对小肝癌的诊断价值。方法nbsp; 搜集16例（21个病灶）经临床和病理证实的小肝癌MR扫描资料，包括平扫及人工手推法动态增强扫描。结果nbsp; 平扫T2WI多呈高信号，T1WI多呈低信号，少数呈等或高信号。23.81％可见假包膜。MRI平扫与动态增强对小肝癌诊断的准确率分别66.67％和95.24％(Plt;0.05)。结论nbsp; 人工手推法Gd-DTPA动态增强较平扫MRI能提高小肝癌的定性准确率。 nbsp;nbsp; ［关键词］nbsp; 人工注射法；动态增强；磁共振扫描；小肝癌 nbsp;nbsp;nbsp; Evaluation of dynamic contrast-enhanced MRI by manual injection in the diagnosis of small HCC nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; nbsp;nbsp;nbsp; ［Abstract］nbsp; Objectivenbsp; To study the diagnostic value of dynamic gadolinium-enhanced MR imaging in small hepotacellular carcinoma (SHCC) by manual injection.Methodsnbsp; The scan date by MRI of 16 cases (21 lesions) with SHCC confirmed by pathology clinic were reviewed，include plain scan and dynamic contrast-enhanced scan by manual injection.Resultsnbsp; On plain scan，most SHCC showed hyperdensity on T2WI.Most SHCC showed hypodensity and a few showed isodensity or hyperdensity on T1WI.Pseudocapsule can be detected in 23.81% cases.On dynamic-enhanced MRI，17 lesions were hypervascular and 4 lesions were hypovascular.Pesudocapsule can be detected in 57.14% cases.The diagnostic accuracy of plain MRI scan and the Gd-DTPA dynamic-enhanced MRI on SHCC were 66.67% and 95.24% (Plt;0.05).Conclusionnbsp; Compared with plain scan，Gd -DTPA dynamic-enhanced MRI by manual injection can promote the diagnostic accuracy of SHCC. nbsp;nbsp;nbsp; nbsp;nbsp;nbsp; ［Key words］nbsp; manual injection;dynamic enhancement;MRI;SHCC nbsp;nbsp;nbsp; nbsp;nbsp;nbsp; 肝细胞癌是较常见的恶性肿瘤，近年来随着影像诊断方法尤其是MRI动态增强扫描的发展，小肝癌（≤3 cm）的检出率不断提高，对延长患者的生存期起到了积极作用。但由于MRI检查费用本身很高，而非磁性高压注射器成本高，使患者经济负担加重，限制了动态增强扫描的使用，因此笔者应用人工快速手推注射造影剂Gd-DTPA的方法行MRI动态增强扫描获得了很好的效果。 nbsp;nbsp;nbsp; nbsp;nbsp;nbsp; 1nbsp; 资料与方法 nbsp;nbsp;nbsp; nbsp;nbsp;nbsp; 1.1nbsp; 一般资料nbsp; 本组16例，男11例，女5例，年龄33~78岁，平均51岁。16例中10例经手术病理证实，4例经穿刺活检病理证实，2例经DSA证实。16例中14例有明确的乙型肝炎病史。12例为单发病灶，3例有两个病灶，1例有三个病灶，共发