MRT1WI梯度回波同反相位序列對肝臟病變的鑒別診斷價值

T1WI梯度回波同、反相位序列對肝臟病變的鑒別診療價值。辦法:回憶性分析76例肝臟結節(jié)在MRT1WI梯度回波同相位與反相位圖像上的信號差別。將76例成果:6組肝臟結節(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)。結論:含有少fi脂肪成分的肝臟病變在MRT1WI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強掃描在鑒別診化，如肝癌結節(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;轉移瘤10例;襄腫10MR掃描技術使用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),翻轉角85，帶寬13，單次屏氣采集，掃描16層，成像時間15閣像分析首先目測肝臟病灶在T1WI圖像上信號強度比值=的平均值，采用SPSS13.0forwindows統(tǒng)計軟件中的方差分析比(11):950?53.276例6組肝臟病變在T1WI同反相位圖像上的信號強度比值見表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組肝臟病變的信號強度比與肝內(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定中非常重要。中，當TE值大概為2.23、6.69、11.15……時，為反相位圖像;當TE值大概為46、8.92、時，為同相位圖像。理論上，1.5TMR的同、反相位圖像的抱負TE4.5ms和偏差，本研究應用的是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強度減少，在與反相位圖像上病變信號強度的變化能判斷病灶內(nèi)與否含有脂肪成分[3]。肝臟結節(jié)內(nèi)少ffl管瘤、轉移瘤及囊腫之間差別有明顯性(均p<0.01)相位上的信號差別值明顯高于其它組，表明其含有鑒別診療價值，與文獻6]、局灶性結節(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用價值[J].中華放射學雜志,,溫新東，李又成,黎金林，等.梯度回波同、反相位T1WI學技術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].