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目的采用改良MRI灌注半定量方法评估肝脏局灶性病变各参数特点及探讨对病变定性的价值。方法应用三维容积式内插技术MRI对70例行不间断扫描,连续采集50期全肝数据,同步经静脉注入对比剂,根据灌注的时间-信号曲线,获得病变的最大信号强度、达峰时间、强化坡度及早期、后期对比剂下降坡度,并进行统计学分析。结果最高信号强度,血管瘤和局灶性结节增生分别为019.01±410.29和916.96±174.28,高于肝细胞癌、转移瘤和肝脓肿(分别为722.47±192.78、744.25±167.42和733.45±242.72)。达峰时间(单位:s),肝细胞癌和转移癌分别为24.49±11.09和31.58±6.96,短于血管瘤和肝脓肿(分别为59.14±20.13和59.63±2.36)。局灶性结节增生为18.55±8.16,达峰时间最短。增强坡度(单位为信号强度/s),肝细胞癌为37.63±30.08,高于转移瘤(为24.90±8.63),两者均高于血管瘤和肝脓肿(分别为59.25±28.82和2.68±4.77)。局灶性结节增生为59.25±28.82,明显高于其他良恶性病变。早期下降坡度和后期下降坡度(单位为信号强度/s),肝细胞癌分别为13.01±22.71和13.01±22.71,肝脓肿分别为16.98±22.26和0.20±0.21,两者高于其他病变。以上数据经方差分析,具有显著性差异(P<0.05)。结论本组数据提示肝脏恶性病变与良性病变具有差异,但局灶性结节增生具有特殊性,应结合形态学改变进行鉴别。应用改良MRI灌注半定量方法分析肝脏局灶性病变,使病变的增强表现准确地参数化,是诊断与鉴别诊断有价值的方法。
Objective To use modified MRI perfusion semi-quantitative method to evaluate the characteristics of various parameters of focal liver lesions and to explore the value of characterization of lesions. Methods Three-dimensional volumetric interpolation technique was used to perform routine MRI scans on 70 consecutive patients and 50 consecutive liver data were collected. Contrast medium was intravenously injected. According to the time-signal curve of perfusion, the maximum signal intensity and peak time of lesions were obtained. , Strengthen the gradient and the decline of the contrast agent in early and late periods, and perform statistical analysis. Results The highest signal intensity, hemangiomas, and focal nodular hyperplasia were 019.01±410.29 and 916.96±174.28, respectively, which were higher than hepatocellular carcinoma, metastases, and hepatic abscesses (722.47±192.78, 744.25±167.42, and 733.45±242.72, respectively). . Peak time (unit: s), hepatocellular carcinoma and metastatic carcinoma were 24.49±11.09 and 31.58±6.96, respectively, shorter than hemangiomas and liver abscesses (59.14±20.13 and 59.63±2.36, respectively). Focal nodular hyperplasia was 18.55±8.16 with the shortest peak time. Increased slope (in units of signal intensity/s), hepatocellular carcinoma was 37.63±30.08, higher than metastasis (24.90±8.63), and both were higher than hemangiomas and liver abscesses (59.25±28.82 and 2.68±4.77, respectively). ). Focal nodular hyperplasia was 59.25±28.82, which was significantly higher than other benign and malignant lesions. The early decline slope and the late fall gradient (in units of signal intensity/s) were 13.01±22.71 and 13.01±22.71 for hepatocellular carcinoma, and 16.98±22.26 and 0.20±0.21 for hepatic abscess, respectively, which were higher than other lesions. The above data were analyzed by variance and showed significant differences (P<0.05). Conclusions The data in this study suggest that there is a difference between malignant liver lesions and benign lesions, but focal nodular hyperplasia has particularity and should be identified in combination with morphological changes. The use of modified MRI perfusion semi-quantitative methods to analyze focal liver lesions and accurately parameterize lesion enhancement is a valuable diagnostic and differential diagnosis method.