MRT1WI梯度回波同反相位序列對(duì)肝臟病變的鑒別診斷價(jià)值

T1WI梯度回波同、反相位序列對(duì)肝臟病變的鑒別診療價(jià)值。辦法:回憶性分析76例肝臟結(jié)節(jié)在MRT1WI梯度回波同相位與反相位圖像上的信號(hào)差別。將76例成果:6組肝臟結(jié)節(jié)在T1WI比值分別為肝癌1.27?0.25,性腫瘤1.06?0.04，肝內(nèi)炎性病變1.22?0.12，1.02?0.12,轉(zhuǎn)移瘤1.02炎性病變兩組之間差別無明顯性前兩組與后四組病變之間差別有明顯性(P〈0.01)。結(jié)論:含有少fi脂肪成分的肝臟病變?cè)贛RT1WI梯MRAbstract:Objective:ToassesstheadvantagesofMRSPGRin-phase(IP)andopposed-phase(OP)Tl-weightedsequencesforthedifferentiationoffocalhepaticlesions.Methods:Twenty-sevenhepatocellularcarcinomas，7benignhepaticneoplasms,11hepaticinflammatorylesions,11hepatic10livermetastases,and10hepaticcystswereretrospectivelyevaluatedat1.5TchemimalshiftMRIusingadouble-echoSPGR(spoiledphasegradientecho,SPGR)sequence.SIR(signalintensityratio,SIR)of76focalhepaticlesionsonIPandOPimageswascalculatedandcomparedusinganalysisofvariance.Results:SIRof76focalhepaticlesionsonIPandOPimageswas1.27+0.25in27hepatocellularcarcinomas,1.06+0.04in7benignhepaticneoplasms,1.22+0.12in11inflammatorylesions,1.02?0.12in11hepatichemangiomas,1.020.06in10livermetastases,and0.99MRT1WI0.07in10hepaticcysts,respectively.NodifferencewasshowedintheSIRbetweenhepatocellularcarcinomasandhepaticinflammatorylesions(P>0.05).TherewasnosignificantdifferenceintheSIRamongbenignhepaticneoplasms,livermetastases,hepatichemangiomas,andhepaticcyst(P>0.05).ButtheSIRofcarcinomasandhepaticinflammatorylesionswassignificantlydifferentfromoneofbenignhepaticneoplasms,livermetastases，hepatichemangiomasandhepaticcystsrespectively(P<0.01).Conclusion:Thesignalintensitiesaresignificantlydifferentbetweenin-phaseandopposed-phaseimagesinfat-orlipid-containingliverlesions.MRSPGRin-phaseandopposed-phaseTl-weightedsequencesarehelpfulinthedifferentialdiagnosisofliverlesions.Keywords:magneticresonanceimaging;1iver;gradient強(qiáng)掃描在鑒別診化，如肝癌結(jié)節(jié)等在鏡下常有多少不一的脂肪變性，而襄腫、血管瘤等鮮有此種變化。MRT1WI梯列能檢測(cè)病變內(nèi)少fi的脂肪成分，因此，本研究旨在探討MR1普通資料76例肝臟閃病變的患者，除10667例;肝內(nèi)炎性病變11例;海綿狀血管瘤11例;轉(zhuǎn)移瘤10例;襄腫10MR掃描技術(shù)使用Signa磁共振儀，相控陣線圈。常規(guī)均行A旋回波(SE)T1加權(quán)300ms,TE16ms,帶寬41.67)及脂肪克制T2WI(TR3000?5000ms,12,帶寬25.00)5_，2mm,380mmX380mm，256X256192X256。T1WI掃描掃描，層厚、間隔、視野均與常規(guī)掃描相似。同(反)相位參數(shù)為175ms,TE4.2ms(2.5ms),翻轉(zhuǎn)角85，帶寬13，單次屏氣采集，掃描16層，成像時(shí)間15閣像分析首先目測(cè)肝臟病灶在T1WI圖像上信號(hào)強(qiáng)度比值=的平均值，采用SPSS13.0forwindows統(tǒng)計(jì)軟件中的方差分析比(11):950?53.276例6組肝臟病變?cè)赥1WI同反相位圖像上的信號(hào)強(qiáng)度比值見表1，肝癌(27見圖A1A2)1.27?0.25,肝內(nèi)良性腫瘤(7例)(見圖Bl、B2)1.06?0.04，肝內(nèi)炎性病變(11例)(見圖Cl、C2)1.22?0.12，海綿狀血管瘤(11例)(見圖Dl、D2)1.02?0.12，轉(zhuǎn)移瘤(10例)(見圖El、1.02+0.06,襄腫(10例)(見圖Fl、F2)0.99?0.07,6組肝臟病變的信號(hào)強(qiáng)度比與肝內(nèi)炎性病變兩組之間差別無明顯性(P>0.病變之間差別亦無明顯性現(xiàn)肝內(nèi)結(jié)節(jié)的脂肪變性并與其它病變的鑒別在臨床診療和追蹤評(píng)定中非常重要。中，當(dāng)TE值大概為2.23、6.69、11.15……時(shí)，為反相位圖像;當(dāng)TE值大概為46、8.92、時(shí)，為同相位圖像。理論上，1.5TMR的同、反相位圖像的抱負(fù)TE4.5ms和偏差，本研究應(yīng)用的是1.5TGESigna磁共振儀，其SPGRTE值分別是4.2ms和2.2ms。脂肪與水含fi相稱的組織在反相位圖像上信號(hào)強(qiáng)度減少，在與反相位圖像上病變信號(hào)強(qiáng)度的變化能判斷病灶內(nèi)與否含有脂肪成分[3]。肝臟結(jié)節(jié)內(nèi)少ffl管瘤、轉(zhuǎn)移瘤及囊腫之間差別有明顯性(均p<0.01)相位上的信號(hào)差別值明顯高于其它組，表明其含有鑒別診療價(jià)值，與文獻(xiàn)6]、局灶性結(jié)節(jié)病例選擇較局限所致。徐海波,孔祥泉，劉定西,等.同相位與反相位梯度回波在肝臟的應(yīng)用價(jià)值[J].中華放射學(xué)雜志,,溫新東，李又成,黎金林，等.梯度回波同、反相位T1WI學(xué)技術(shù)MerkleEM,NelsonRC.DualGradient-EchoIn-PhaseandOpposed-PhaseHepaticMRImaging:AUsefulToolforEvaluatingMoreThanFattyInfiltrationorFattySparing[J].RadioGraphics，，26(5):1409-1418.[6]WillattJM,HussainHK,AdusumilliS,etal.MRImagingofHepatocellularCarcinomaintheCirrhoticLiver:Challengesand,247(2):311-[7]PrasadSR,WangH，RosasH,etal.Fat-containinglesionsoftheliver:radiologic-pathologiccorrelation[J].