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[目的]探讨肝脏局灶性结节增生(FNH)和小肝细胞癌(SHCC)在MRI平扫、增强扫描和DWI参数上的差异。[方法]选取SHCC及FNH患者57例。分析MRI鉴别SHCC与FNH的平扫、增强扫描和DWI、曲线下面积(AUC)等参数差异。[结果 ]在T1WI表现上,FNH等信号病灶12个(57.14%),SHCC低信号病灶37个(84.09%);在动态增强门静脉期T1WI表现上,FNH高信号病灶15个(71.43%),SHCC低信号病灶26个(59.09%),2组信号等级分类差异具有统计学意义(Z=-4.518、-5.723,P<0.05);在T2WI和DWI表现上,2组病灶均以高信号为主,差异不具有统计学意义(Z=-1.318、-1.431,P>0.05)。T1WI的ROC曲线下面积为0.698,特异性为81.4%,灵敏度为58.7%;多期动态增强门静脉T1WI的ROC曲线下面积为0.892,特异性和灵敏度分别为61.0%和100.0%。[结论]SHCC与FNH的鉴别诊断中MRI平扫T1WI和多期动态增强门静脉期T1WI的诊断价值较高,而DWI和T2WI对鉴别诊断能起到一定辅助作用。
[Objective] To investigate the difference of MRI plain scan, enhanced scan and DWI parameters between hepatic focal nodular hyperplasia (FNH) and small hepatocellular carcinoma (SHCC). [Methods] 57 cases of SHCC and FNH were selected. Analyze MRI to identify the differences between the plain scan, DWI, area under the curve (AUC) and other parameters of SHCC and FNH. [Results] There were 12 (57.14%) FNH and 37 (84.09%) lesions with low FNH and 15 lesions (71.43%) in T1WI with dynamic enhancement of portal vein, There were 26 low-signal lesions (59.09%) in SHCC, and the difference of signal classification between the two groups was statistically significant (Z = -4.518, -5.723, P <0.05); in T2WI and DWI, The difference was not statistically significant (Z = -1.318, -1.431, P> 0.05). The area under ROC curve of T1WI was 0.698, the specificity was 81.4% and the sensitivity was 58.7%. The area under the ROC curve of T1WI with multi-period dynamic enhancement of portal vein was 0.892, the specificity and sensitivity were 61.0% and 100.0% respectively. [Conclusion] The diagnostic value of MRI plain T1WI and multi-phase dynamic enhanced portal vein T1WI in the differential diagnosis of SHCC and FNH is higher, while DWI and T2WI can play a supporting role in the differential diagnosis.