Yu J S, Kim K W, Lee J T, Yoo H S
Department of Diagnostic Radiology and the Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2000 Oct;41(5):546-55. doi: 10.3349/ymj.2000.41.5.546.
The purpose of this study was to document the additional value of MR imaging during arterial portography (MRAP) in patients examined with intravenous contrast-enhanced dynamic MR imaging for the assessment of focal lesions in patients with cirrhosis or chronic viral hepatitis. The MR images of 24 patients with 39 hepatocellular carcinomas and 18 benign hepatocellular nodules examined with dynamic MR imaging and MRAP within a 14-day interval were retrospectively reviewed. For 39 hepatocellular carcinomas, MRAP revealed 37 perfusion defects (95%), while dynamic MR imaging demonstrated 35 occurrences of nodular contrast-enhancement (90%) on arterial dominant phases. Among the 11 benign nodules misinterpreted as hepatocellular carcinoma due to their high signal intensities on arterial-dominant phases of dynamic MR imaging, eight (73%) showed intratumoral portal venous perfusion on MRAP and were regarded as benign nodules. As a result of its high sensitivity and its potential ability to enable differentiation of benign and malignant hepatocellular nodules, MRAP can be added to dynamic MR imaging for planning future management in patients with equivocal hepatocellular nodules in the cirrhotic liver.
本研究的目的是记录在接受静脉注射对比剂增强动态磁共振成像（MRI）检查以评估肝硬化或慢性病毒性肝炎患者局灶性病变的患者中，动脉期门静脉造影磁共振成像（MRAP）的附加价值。回顾性分析了24例患者的MR图像，这些患者在14天内接受了动态MRI和MRAP检查，其中有39个肝细胞癌和18个良性肝细胞结节。对于39个肝细胞癌，MRAP显示37个灌注缺损（95%），而动态MRI在动脉期显示35个结节性对比增强（90%）。在11个因动态MRI动脉期高信号强度而被误诊为肝细胞癌的良性结节中，8个（73%）在MRAP上显示瘤内门静脉灌注，并被视为良性结节。由于其高敏感性以及能够区分良性和恶性肝细胞结节的潜在能力，MRAP可添加到动态MRI中，用于规划肝硬化肝脏中肝细胞结节不明确患者的未来治疗方案。
