CAJ | 학술논문

目的：探讨肝脏肿瘤灶在MRI三期增强扫描中出现不同强化方式对日常扫描工作指导意义。方法收集经我院病理科证实的100例肝肿瘤患者，其中原发性肝癌43例；肝转移癌57例。所有病例由同一技师先进行标准的MRI三期增强扫描；扫描技师可根据临床需要在扫描最后增加第四期延迟扫描。并由我科室两位副高以上诊断医师评估肝内病灶的强化情况，出具带有详尽描述的诊断报告。结果肝脏原发灶有42例表现为造影剂“快进快出”[1]的增强模式，即动脉期强化明显、门脉期信号降低、延迟期信号最低；仅有1例表现为动脉期低信号，延迟期信号最强的情况。肝脏转移灶39例表现为动脉期信号最低，门脉期、延迟期信号逐渐增强；有18例病人在前三期均未明显强化，在最后加扫的延迟期病灶才逐渐强化。结论肝脏原发性肿瘤灶在MRI三期增强扫描中具备典型的造影剂“快进快出”模式，而肝脏转移性病灶则呈现为“慢进慢出”[2]的造影剂增强模式。这就要求我们扫描技师在日常操作过程中，灵活地对不同的病变给出最恰当的扫描方式，尽可能多的将病灶信息提供给临床医生。
목적：탐토간장종류조재MRI삼기증강소묘중출현불동강화방식대일상소묘공작지도의의。방법수집경아원병이과증실적100례간종류환자，기중원발성간암43례；간전이암57례。소유병례유동일기사선진행표준적MRI삼기증강소묘；소묘기사가근거림상수요재소묘최후증가제사기연지소묘。병유아과실량위부고이상진단의사평고간내병조적강화정황，출구대유상진묘술적진단보고。결과간장원발조유42례표현위조영제“쾌진쾌출”[1]적증강모식，즉동맥기강화명현、문맥기신호강저、연지기신호최저；부유1례표현위동맥기저신호，연지기신호최강적정황。간장전이조39례표현위동맥기신호최저，문맥기、연지기신호축점증강；유18례병인재전삼기균미명현강화，재최후가소적연지기병조재축점강화。결론간장원발성종류조재MRI삼기증강소묘중구비전형적조영제“쾌진쾌출”모식，이간장전이성병조칙정현위“만진만출”[2]적조영제증강모식。저취요구아문소묘기사재일상조작과정중，령활지대불동적병변급출최흡당적소묘방식，진가능다적장병조신식제공급림상의생。
Objective To Explore the diagnostic significances of different enhancement ways of liver tumor in daily scanning. Methods 100 patients with liver tumors confirmed by pathology were collected. 43 cases were primary liver cancer, and 57 cases were hepatic metastatic carcinoma. All cases underwent three phases enhancement by the same technician. Extra delay phase scanning would be performed by the technician according to clinical needs. The enhancement changes of focuses were envaluated by two vice-senior title or senior title doctors, and the detailed diagnostic report were provided by them. Results Liver primary tumors in 42 cases showed contrast agents "fast into fast out"enhancement mode(obvious enhancement in aterial phase, decreased signal in portal phase, and the lowest signal in delay phase), and only 1 case showed low signal in the arterial phase and the highest signal in the delay phase. 39 cases with liver metastases showed the lowest signal in the arterial phase and the signal increased gradually in the portal, and delay pahses, and 18 patients showed no obvious enhancement in three phases and enhanced gradually in the extra delayed pahse. Conclusion Primary liver tumors show the typical"fast into fast out"enhancement mode, and liver metastasis focuses show"slow in slow out" enhancement mode in MRI three phases enhancement. This requests our technicians choose appropricate scanning method flexiblly in our daily work, and provide information about focuses as much as possible for clinical doctor.