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目的比较乙肝肝硬化背景小肝癌(SHCC)CT与MRI的强化特征。方法 87例乙肝肝硬化SHCC患者共计91个病灶均行CT和MRI动态增强扫描,分别测量病灶平扫及增强各期CT值和MRI信号强度值,计算增强后CT与MRI各期相对强化率和病灶-肝脏对比率,绘制时间-密度/信号强度曲线并分型,观察记录病灶CT与MRI动脉期强化方式及假包膜的显示情况,分析比较乙肝肝硬化背景SHCC CT与MRI的强化特征。结果 MRI动脉期及平衡期SHCC相对强化率较CT高,差异有统计学意义(P<0.05),CT与MRI门静脉期SHCC相对强化率差异无统计学意义(P>0.05)。MRI动脉期、门静脉期及平衡期SHCC病灶-肝脏对比率均较CT高,差异均有统计学意义(P<0.05)。CT与MRI SHCC时间-密度/信号强度曲线类型差异有统计学意义(P<0.05),两两比较速升速降型及速升缓降型差异有统计学意义(P<0.05),缓慢上升型及基本无强化型差异无统计学意义(P>0.05)。CT与MRI SHCC动脉期强化方式差异无统计学意义(P>0.05)。MRI动态增强SHCC假包膜显示率较CT高,差异有统计学意义(P<0.05)。结论 CT和MRI动态增强都能很好地反映SHCC相对肝实质的“快进快出”的强化方式,MRI对显示SHCC动脉期快速强化的特征及假包膜较CT有优势,而CT更有利于观察SHCC强化“退出”的特点。
Objective To compare the enhanced features of CT and MRI in small hepatocellular carcinoma (SHCC) with cirrhosis of the liver. Methods A total of 91 lesions of 87 patients with hepatocirrhosis were enrolled in this study. CT and MRI dynamic contrast-enhanced scans were performed in 87 patients with cirrhosis of the liver. The CT and MRI signal intensity of each lesion were measured, and the relative enhancement rates Lesion-liver contrast ratio, plotting time-density / signal intensity curve and classification. The enhancement modes of arterial phase and pseudocapsule of CT and MRI lesions were observed and compared, and the enhanced features of SHCC CT and MRI of cirrhosis were analyzed. Results The relative enhancement rate of SHCC in arterial phase and balance phase of MRI was higher than that of CT (P <0.05). There was no significant difference in the relative enhancement rate of SHCC between CT and MRI in portal venous phase (P> 0.05). MRI arterial phase, portal vein phase and balance SHCC lesion - liver contrast ratio were higher than CT, the difference was statistically significant (P <0.05). There was a significant difference in the type of time-density / signal intensity curve between SHCC and MRI (P <0.05), and there was a statistically significant difference (P <0.05) There was no significant difference in type and basic non-enhancement (P> 0.05). There was no significant difference in arterial phase enhancement between CT and MRI SHCC (P> 0.05). MRI dynamic enhanced SHCC pseudocapsule showed a higher rate of CT, the difference was statistically significant (P <0.05). Conclusions The dynamic enhancement of CT and MRI can all well reflect the “fast-forward-fast-out” enhancement mode of hepatic parenchyma in SHCC. MRI shows the rapid enhancement of arterial phase in SHCC and the advantage of pseudocapsule compared with CT. More conducive to observe the SHCC strengthen “Exit ” features.