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目的评价Propeller LAVA序列MR动态增强对慢性肝病背景下动脉期强化小结节(≤3.0 cm)的诊断价值。方法回顾分析132例经组织学和(或)临床实验室检查证实的慢性肝病者Propeller LAVA增强检查资料,观察动脉期强化小结节的血供特点、强化规律及程度。结果所有患者中,89例153个结节(0.5~3.0 cm)符合本组纳入要求,其中<2.0 cm圆形或卵圆形结节62个,≥2.0 cm 55个,其他形状36个。90个肝细胞癌结节中,与邻近肝实质比较,62个在门静脉期和延迟期表现为低信号结节,21个略低于邻近肝实质,7个信号强度近似于邻近肝实质。肝血管瘤20个,15个T2 WI信号强度类似于脑脊液,5个略低于脑脊液;动脉期10个边缘结节状强化,8个均匀强化,2个周边见楔状高信号;门静脉期和延迟期均表现为稍高于或等于邻近肝实质的强化结节。动脉门静脉分流40个,动脉期位于肝脏中心或周边部分的卵圆形、楔形或三角形强化影,随时间延迟与邻近肝实质信号强度一致。局灶结节增生3个,动脉期强化程度近似于同层面腹主动脉,门静脉期和延迟期与邻近肝实质信号强度近似。结论 Propeller LAVA序列可准确显示慢性肝病患者动脉期强化小结节的血供特点、形态、边缘及其组织学性质。
Objective To evaluate the diagnostic value of MR dynamic enhancement of Propeller LAVA sequence in arterial phase with small nodules (≤3.0 cm) in the context of chronic liver disease. Methods Retrospective analysis of 132 cases of chronic liver disease confirmed by histological and (or) clinical laboratory tests enhanced Propeller LAVA data to observe the arterial phase enhanced small nodules blood supply characteristics, strengthen the law and degree. Results A total of 89 patients with 153 nodules (0.5-3.0 cm) were eligible for inclusion in this study. Among them, 62 were round or oval nodules, 55 were ≥ 2.0 cm and 36 were other shapes. In 90 hepatocellular carcinoma nodules, compared with the adjacent liver parenchyma, 62 showed low signal nodules in the portal venous phase and the delayed phase, 21 slightly lower than the adjacent liver parenchyma and 7 signal intensity similar to the adjacent liver parenchyma. 20 hepatic hemangiomas, 15 T2WI signal intensity similar to cerebrospinal fluid, 5 slightly lower than cerebrospinal fluid; arterial phase 10 edge nodular enhancement, 8 uniform enhancement, 2 peripheral wedge-shaped high signal; portal vein phase and delay Period showed a slightly higher than or equal to the enhanced parenchymal nodules. Arterial portal vein shunt 40, arterial phase located in the center of the liver or peripheral part of the oval, wedge-shaped or triangular enhanced shadow, with the time delay and adjacent liver parenchymal signal intensity. Focal nodules hyperplasia 3, the degree of arterial phase enhancement is similar to the same level of the abdominal aorta, portal vein phase and the adjacent liver parenchyma signal intensity approximation. Conclusion The Propeller LAVA sequence can accurately show the characteristics, morphology, margins and histological features of small nodules during arterial phase in patients with chronic liver disease.