相位校正多回波GRE Dixon序列在原发性肝癌诊断价值的初步探讨

摘要

AbstractObjective:To clarify the significance of multi-echo GRE Dixon in the diagnosis of primary hepatocarcinoma.Materials and Methods:Twenty-two patients with hepatocarcinoma proved pathologically by surgery and biopsy underwent liver MRI scanning with a phase correction multi-echo GRE Dixon sequence. We analyze their imaging features of tumor in water only imaging, fat only imaging, water/fat phase mapping, R2* mapping and make a contrast with imaging of in-phase and opposed-phase, T2 weighted imaging and histopathological results.Results:Intrahepatic cholangiocarcinoma and hepatocellular carcinoma with fatty degeneration usually shows hypointensity on water only imaging and hepatocellular carcinoma without fatty degeneration shows isointensity on water only image. Most of the tumors can be seen more necrosis and hemorrhage on R2* mapping than T2 weighted imaging. The value of R2* of Intrahepatic cholangiocarcinoma is lower than that of Hepatocellular carcinoma and theP value is 0.003. R2* mapping has a lower contrast to noise ratio of tumor and hepatic tissue than T2 weighted imaging.Conclusion:We can distinguish necrosis, hemorrhage, fatty degeneration and fibre in the liver tumor by phase correction multi-echo GRE Dixon, which plays an important role in the differential diagnosis of intrahepatic cholangiocarcinoma and hepatocarcinoma.%目的：初步探讨相位校正多回波GRE Dixon序列在原发性肝癌诊断中的作用。材料与方法利用GRE Dixon序列扫描22例原发性肝癌患者，分析其在GRE Dixon序列生成的水像、脂像、水/脂相位图、R2*像的影像特点，并与传统T1、T2像及病理结果对照。结果胆管细胞癌与含脂肝细胞癌在水像上大多呈低信号，不含脂的肝细胞癌在水像上大多呈等信号。多数肿瘤中的出血、坏死在R2*像能够显示，优于T2像。胆管细胞癌的R2*值低于肝细胞癌(P=0.003)。R2*像中肿瘤与肝组织的对比噪声比低于T2像。结论分析相位校正多回波GRE Dixon的图像能够判断肝脏肿瘤组织内的出血、坏死、脂变、纤维成份，有利于胆管细胞癌与肝细胞癌的鉴别。