Honda H, Kaneko K, Maeda T, Kuroiwa T, Fukuya T, Yoshimitsu K, Irie H, Aibe H, Takenaka K, Masuda K
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Invest Radiol. 1997 Mar;32(3):161-8. doi: 10.1097/00004424-199703000-00005.
The authors discuss the clinicopathologic features and angiographic vascularity of various signal intensity patterns on magnetic resonance (MR) imaging of small hepatocellular carcinomas (HCCs).
Magnetic resonance images of 88 resected HCCs (< or = 3 cm) were obtained using T1- and T2-weighted spin-echo images and T1-weighted images after gadolinium (Gd)-DTPA administration. Images were compared with angiographic and histopathologic findings.
Forty HCCs (45%) were depicted on T1-weighted images, 51 (58%) on T2-weighted images, and 41 (49%) on T1-weighted images after Gd-DTPA administration. Overall, 64 (76%) were found on at least one image. On T1-weighted images, hyperintense HCCs histologically showed fatty metamorphosis and portal tracts within the tumor. On T2-weighted images, HCC hyperintensity correlated with expansive growth, peliotic change, and hypervascularity. By contrast, HCCs that were undetected or hypointense on T2-weighted images were well differentiated with replacing growth and portal tracts. On T1-weighted images after Gd-DTPA, hyperintense HCCs had peliotic change; undetected HCCs were well differentiated and hypovascular.
Histologic grade, vascularity, portal tracts and peliotic change correlate with MR signal intensity. For hyperintense HCCs on T1-weighted images and hypo- or isointense HCCs on T2-weighted images, treatment methods must be assigned with the consideration that HCCs may be receiving transsinusoidal and portal blood supplies.
作者探讨了小肝细胞癌（HCC）磁共振成像（MR）上各种信号强度模式的临床病理特征及血管造影的血管情况。
使用T1加权和T2加权自旋回波图像以及钆（Gd）-二乙三胺五乙酸（DTPA）给药后的T1加权图像，获取了88例切除的HCC（直径≤3cm）的磁共振图像。将图像与血管造影和组织病理学结果进行比较。
40例（45%）HCC在T1加权图像上显示，51例（58%）在T2加权图像上显示，41例（49%）在Gd-DTPA给药后的T1加权图像上显示。总体而言，64例（76%）在至少一幅图像上被发现。在T1加权图像上，高信号的HCC在组织学上显示有脂肪变性和肿瘤内的门静脉分支。在T2加权图像上，HCC高信号与膨胀性生长、血池样改变和血管丰富相关。相比之下，在T2加权图像上未被发现或呈低信号的HCC分化良好，呈替代生长且有门静脉分支。在Gd-DTPA给药后的T1加权图像上，高信号的HCC有血池样改变；未被发现的HCC分化良好且血管少。
组织学分级、血管情况、门静脉分支和血池样改变与MR信号强度相关。对于T1加权图像上的高信号HCC以及T2加权图像上的低信号或等信号HCC，在制定治疗方案时必须考虑到HCC可能接受经窦状隙和门静脉血供。
