代偿期肝硬化MRI常规序列形态学分析和信号测量研究

摘要

Objective:To explore the diagnostic value of MRI conventional sequences by morphologic analysis and signal mea-surement in patients with compensatory phase liver cirrhosis. Methods:One hundred and eighty-four cases with compensatory phase liver cirrhosis and 125 normal cases were imaged with MR conventional sequences. The shape was analyzed and signal intensity was measured in images of T1WI,T1WI with fat-suppression (T1WI-FS),T2WI and T2WI-FS. The signal intensity was compared between 184 cases with compensatory phase liver cirrhosis and 125 normal cases. Results:Slight high or high signal small or thin nodules were visible on T1WI and T1WI-FS in 139 (75.54%) cases with compensatory phase liver cirrhosis ,and low signal small or thin nodules on T2WI and T2WI-FS in 78 (42.39%) cases. There were big and small nodules or wavilness on liver surface in 105 (57.07%) cases,wide liver splits in 86 (46.74%) cases and shrunken liver in 43 (23.37%) cases. The splenomegaly was visible in 156 (84.78%) cases. There were signs of portal hypertension in 15 (8.15%) cases. The signal in-tensity of liver on T1WI and T1WI-FS in cases with compensatory phase liver cirrhosis was significantly lower than that in nor-mal cases (P<0.05),and on T2WI and T2WI-FS in cases with compensatory phase liver cirrhosis significantly higher than that in normal cases (P<0.05). Conclusion:MRI conventional sequences are sensitive and convenient for diagnosis of compensatory phase liver cirrhosis. The signal intensity of liver reflects pathological change of compensatory phase cirrhotic liver,in a way.%目的:探讨MRI常规序列形态学分析和信号测量对代偿期肝硬化的诊断价值. 方法:回顾性分析184例代偿期肝硬化患者(实验组)的上腹部MRI常规T1WI、FS-T1WI、T2WI和FS-T2WI图像,测量其信号强度,并与125例正常人(对照组)进行比较.结果:代偿期肝硬化T1WI及FS-T1WI示肝实质有稍高或高信号小或细小结节139例(75.54%);T2WI、FS-T2WI示肝实质有低信号小或细小结节 78 例(42.39%);肝脏表面不光滑,呈大小不等结节状或波浪状改变 105 例(57.07%);肝裂增宽 58 例(31.52%);肝叶比例失调86例(46.74%);肝脏缩小43例(23.37%);脾大156例(84.78%);门静脉高压征象15例(8.15%),包括门静脉、脾静脉增粗以及食管下段、胃底等静脉曲张. 肝脏信号强度T1WI及FS-T1WI实验组显著低于对照组(P<0.05),T2WI及FS-T2WI显著高于对照组(P<0.05). 结论:MRI常规序列形态学分析对代偿期肝硬化的诊断敏感且操作简便;肝脏信号强度在某种程度上可反映代偿期肝硬化肝脏的病理变化.