肝臟局灶性病變的強化方式在其定性診斷中的價值_《中國普外基礎與臨床雜志》

作者：

劉杰 ¹ , 宋彬 ¹ , 徐雋 ²

1.四川大學華西醫院放射科（成都 610041）;;
2.四川省第四人民醫院CT室（成都2610016）;;
通訊作者: 宋彬;

關鍵詞：

肝臟局灶性病變磁共振成像三維容和式內插值法屏氣檢查

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目的探討肝臟局灶性病變（FHL）的強化方式在其定性診斷中的價值。
方法前瞻性納入47例FHL病例（50個病灶），采用MRI三維容積式內插值法屏氣檢查序列（3D-VIBE）對病灶進行包括動脈早期、動脈晚期和門靜脈期在內的多期動態增強掃描，分析3DVIBE序列所顯示的病灶形態學特點和測量病灶的對比噪聲比，重點觀察病灶的強化方式和強化方式的動態演變過程。
結果①17例（20個病灶）肝細胞肝癌（HCC）多表現為“動脈期快進、門靜脈期快出”的強化方式，60％的HCC出現“假包膜”，65％合并肝硬變背景； ②3例膽管細胞肝癌動脈期輕度強化，門靜脈期及延遲期強化，67％合并有病灶周圍近側肝內膽管的擴張； ③12個（100％）轉移性肝癌均表現為周邊程度不一的環形強化； ④肝血管瘤在動脈早期邊緣呈周邊結節樣強化，并隨時間推移出現向心性的“推進式”強化； ⑤4例細菌性肝膿腫主要表現為膿腫壁的簇狀或環形強化和內部纖維分隔的輕度強化， 1例嗜酸性肉芽腫僅輕度強化。
結論FHL的形態學特征以及動脈期的強化特點和強化演變方式對定性診斷幫助較大； MRI 3D-VIBE序列多期動態掃描是提供上述信息的最優影像學技術。

引用本文： 劉杰,宋彬,徐雋. 肝臟局灶性病變的強化方式在其定性診斷中的價值. 中國普外基礎與臨床雜志, 2006, 13(4): 474-478. doi: 復制

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2. Radiographics, 2002; 22(5)∶1023.
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7. Peripheral lowdensity area of hepatic tumors: CTpathologic correlation [J].
8. Radiology, 1986; 160(1)∶49.
9. Hepatocellular carcinoma: correlation of MR imaging and histopathologic findings [J].
10. Radiology, 1992; 183(3)∶819.
11. The pseudocapsule in hepatocellular carcinoma: correlation between dynamic MR imaging and pathology [J].
12. Eur Radiol, 1999; 9(1)∶62.
13. Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies [J].
14. Radiology, 1986; 159(2)∶371.
15. Hepatocellular carcinoma: MR imaging [J].
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17. Small hepatocellular carcinoma: evaluation of portal blood flow with CT during arterial portography performed with balloon occlusion of the hepatic artery [J].
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20. Radiographics, 2005; 25(5)∶1299.
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25. Semelka RC, Hussain SM, Marcos HB, et al.
26. Muramatsu Y, Takayasu K, Moriyama N, et al.
27. Kadoya M, Matsui O, Takashima T, et al.
28. Grazioli L, Olivetti L, Fugazzola C, et al.
29. Ebara M, Ohto M, Watanabe Y, et al.
30. Itoh K, Nishimura K, Togashi K, et al.
31. Saitoh S, Ikeda K, Koida I, et al.
32. Dooms GC, Kerlan RK Jr, Hricak H, et al. Cholangiocarcinoma: imaging by MR [J]. Radiology, 1986; 159(1)∶89.
33. Elsayes KM, Narra VR, Yin Y, et al.
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35. 段承祥，呂桃珍，陶文照，等. 肝血管瘤CT表現的病理基礎 [J]. 中華放射學雜志， 1999; 24（2）∶263.
36. Yamashita Y, Ogata I, Urata J, et al.
37. Mendez RJ, Schiebler ML, Outwater EK, et al. Hepatic abscesses: MR imaging findings [J]. Radiology, 1994; 190(2)∶431.

《中國普外基礎與臨床雜志》

肝臟局灶性病變的強化方式在其定性診斷中的價值

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《中國普外基礎與臨床雜志》

肝臟局灶性病變的強化方式在其定性診斷中的價值

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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