Lang Y, Ma C Q, Deng L W, Wang J, Liu C, Xiao S L, Deng J, Li Q, Liu W W, Yang D S, Li X M
Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China Department of Radiology, The People's Hospital of Shizhu, Chongqing 409100, China.
Department of Radiology, The People's Hospital of Shizhu, Chongqing 409100, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Oct 20;30(10):1069-1073. doi: 10.3760/cma.j.cn501113-20200803-00432.
To differentiate hyperintense hepatocellular carcinoma (HCC) with focal nodular hyperplasia (FNH) in the hepatobiliary phase by MRI multimodal parameters. A retrospective cross-sectional study method was adopted. Clinical data on 15 cases with hyperintense HCC and 15 cases with FNH in the hepatobiliary phase admitted to the First Affiliated Hospital of the Army Medical University from January 2012 to December 2019 were collected. All patients with solitary lesions who underwent Gd-EOB-DTPA-enhanced MRI examinations were included. Surgically resected specimens were verified by pathological and immunohistochemical examination. HCC and FNH imaging features were analyzed by two radiologists. (1) HCC and FNH apparent diffusion coefficient (ADC) values were 1 205.07±239.65×10 mm/s and 1 434.73±217.6×10 mm/s, respectively, and the SI difference was statistically significant (<0.05) between the two groups. (2) In the dynamic contrast-enhanced MRI sequence, 15 cases of HCC were significantly enhanced in the arterial phase, of which 13 cases were characterized by continuous enhancement, and 2 cases were characterized by wash-in and wash-out enhancement. There was no statistically significant difference (>0.05) between the two groups. SI between HCC and FNH (1.39±0.60 . 1.33±0.50, >0.05) had no significant difference. (3) HCC and FNH morphological features in the hepatobiliary phase included: annular hypointensity: HCC (8 cases) vs. FNH (0 cases); contrast filling defects: HCC (8 cases) vs. FNH (0 cases); linear hyposignal separation: HCC (10 cases) vs. FNH (0 cases); and stellate scars: HCC (0) vs. FNH (5 cases), and there were statistically significant differences (<0.05) between the two groups . Multimodal MRI have significant value for differentiating hyperintense HCC and FNH in the hepatobiliary phase.
通过MRI多模态参数鉴别肝胆期高强化肝细胞癌（HCC）与局灶性结节性增生（FNH）。采用回顾性横断面研究方法。收集2012年1月至2019年12月陆军军医大学第一附属医院收治的15例肝胆期高强化HCC患者和15例肝胆期FNH患者的临床资料。纳入所有接受钆塞酸二钠增强MRI检查的孤立性病变患者。手术切除标本经病理和免疫组化检查验证。由两名放射科医生分析HCC和FNH的影像特征。（1）HCC和FNH的表观扩散系数（ADC）值分别为1 205.07±239.65×10⁻³mm²/s和1 434.73±217.6×10⁻³mm²/s，两组间信号强度（SI）差异有统计学意义（<0.05）。（2）在动态对比增强MRI序列中，15例HCC在动脉期明显强化，其中13例表现为持续强化，2例表现为快进快出强化。HCC与FNH之间的SI差异无统计学意义（>0.05）（1.39±0.60、1.33±0.50，>0.05）。（3）肝胆期HCC和FNH的形态学特征包括：环形低强化：HCC（8例） vs. FNH（0例）；对比剂充盈缺损：HCC（8例） vs. FNH（0例）；线性低信号分隔：HCC（10例） vs. FNH（0例）；星芒状瘢痕：HCC（0例） vs. FNH（5例），两组间差异有统计学意义（<0.05）。多模态MRI对鉴别肝胆期高强化HCC和FNH具有重要价值。
