CAJ | 학술논문

目的：探讨钆塞酸二钠增强MRI检查在肝脏结节性病变中的诊断价值。方法疑似为肝脏结节性病变的50例患者，所有患者依次行MRI平扫、钆塞酸二钠动态增强扫描及延迟肝细胞特异期扫描。结果50例患者共发现局灶性结节73枚。病理或临床诊断肝细胞肝癌（HCC）25例、肝脏转移瘤7例，再生结节（RN）5例，退变结节（DN）6例，肝血管瘤6例，肝脏局灶性结节性增生（FNH）2例，肝腺瘤1例。钆塞酸二钠增强MRI共诊断HCC 24例，肝脏转移瘤7例，RN 5例，DN 6例，肝血管瘤6例，FNH 2例，肝腺瘤1例，总体符合率98．1％。钆塞酸二钠增强MRI动脉期、门脉期和平衡期所有病灶符合应用常规含钆（ Gd）剂时的强化表现和特征，延迟20 min肝细胞特异期扫描时，大部分恶性结节呈现低信号，仅1例肝细胞肝癌呈稍高信号，大部分良性结节呈高信号，但肝血管瘤呈低信号。结论采用钆塞酸二钠行MRI动态增强扫描对肝脏结节性病变的诊断有较好的诊断价值，尤其是钆塞酸二钠动态增强扫描与肝细胞特异期扫描联合应用，可以提供病变形态、血供、细胞来源及功能等更多相关信息，从而提高诊断准确性。
목적：탐토구새산이납증강MRI검사재간장결절성병변중적진단개치。방법의사위간장결절성병변적50례환자，소유환자의차행MRI평소、구새산이납동태증강소묘급연지간세포특이기소묘。결과50례환자공발현국조성결절73매。병리혹림상진단간세포간암（HCC）25례、간장전이류7례，재생결절（RN）5례，퇴변결절（DN）6례，간혈관류6례，간장국조성결절성증생（FNH）2례，간선류1례。구새산이납증강MRI공진단HCC 24례，간장전이류7례，RN 5례，DN 6례，간혈관류6례，FNH 2례，간선류1례，총체부합솔98．1％。구새산이납증강MRI동맥기、문맥기화평형기소유병조부합응용상규함구（ Gd）제시적강화표현화특정，연지20 min간세포특이기소묘시，대부분악성결절정현저신호，부1례간세포간암정초고신호，대부분량성결절정고신호，단간혈관류정저신호。결론채용구새산이납행MRI동태증강소묘대간장결절성병변적진단유교호적진단개치，우기시구새산이납동태증강소묘여간세포특이기소묘연합응용，가이제공병변형태、혈공、세포래원급공능등경다상관신식，종이제고진단준학성。
Objective To discuss the value of Gd-EOB-DTPA-enhanced MRI in diagnosis of nodular pathologic changes of liver. Methods In 50 patients suspected of nodular pathologic changes of liver,the MRI plain scanning,dynamic Gd-EOB-DTPA-enhanced MRI and delayed specificity scanning of hepatic cells were performed. Results 73 focal nodular hyperplasia cases were found on the 50 patients,including 25 cases of pathological or clinical diagnosis of HCC,7 cases of liver metastases,5 cases of RN,6 cases of DN,6 cases of hepatic hemangioma,two cases of FNH and 1 case of hepatic adenomas. Through the Gd-EOB-DTPA-enhanced MRI, 24 cases of HCC,7 cases of liver metastases,5 cases of RN,6 cases of DN,6 cases of hepatic hemangioma,two cases of FNH and one case of hepatic adenomas were found,achieving the overall coincidence rate of 98. 1%. In the arterial phase,portal phase and phase bal?ance,all lesions in the Gd-EOB-DTPA-enhanced MRI were in line with the performance and features of using the conventional gado?linium ( Gd) -contained agent. When the specificity scanning of hepatic cells delayed 20 minutes, most of the malignant nodules ap?peared low signal,but a case of hepatocellular carcinoma showed a slightly higher signal. In addition,most benign nodules showed high signal,and hepatic hemangioma cases showed low signal. Conclusion The dynamic Gd-EOB-DTPA enhanced MRI is meaningful for the diagnosis of nodular pathologic changes of liver. Especially,joint usage of dynamic Gd-EOB-DTPA-enhanced MRI and the liver parenchyma scanning can provide the information about lesion type,blood supply,and cell source and so on,thereby increasing diagnostic accuracy.