MRI、DSA和碘油CT联合应用对肝硬化结节癌变的诊断价值.doc

《 中国癌症杂志》2012年第22卷第5期 377 CHINA ONCOLOGY 2012 Vol.22 No.5 MRI、DSA和碘油CT联合应用 对肝硬化结节癌变的诊断价值 曹捍波 张铁英 严金岗 舟山医院放射科,浙江 舟山 316000 [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。 [关键词] 磁共振成像;血管造影;碘油CT;肝硬化结节;癌变 DOI:10.3969/j.issn.1007-3969.2012.05.011 中图分类号:R730.42 文献标志码:A 文章编号:1007-3639201205-0377-04 The value of MRI, DSA and lipiodol CT in the diagnosis of hepatocellular carcinoma with dysplastic nodule in liver cirrhosis CAO Han-bo, ZHANG Tie-ying, YAN Jin-gang Department of Radiology, People’s Hospital of Zhoushan City, Zhoushan Zhejiang 316004, China Correspondence to:CAO Han-bo E-mail:zjzszhy@163 [Abstract] 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 CTResults: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 T2WIAmong 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.