Sequential hemodynamic changes in precancerous lesions of hepatocellular carcinoma: experimental study with MR perfusion
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1005-1201.2006.03.003
- Key Word:
- 癌,肝细胞;癌前状态;磁共振成像;灌注,局部;大鼠
Abstract： 目的探讨原发性肝细胞癌(HCC)癌前病变血液动力学的特征.方法用MR灌注扫描(MR perfusion, MRP)的方法对实验诱发大鼠肝脏的HCC癌前病变阶段到癌变阶段的血液动力学进行动态观察.结果在MR T2WI检出并与病理对应良好的46个结节中有9个再生结节(regenerative nodule, RN)、22个HCC癌前病变即发育不良结节(dysplastic nodule,DN)、10个早期HCC和5个HCC.RN、DN、早期HCC和HCC结节及邻近肝实质的平均阳性强化积分值(positive enhancement integral, PEI)分别为205.67±31.17、161.94±20.74、226.09±34.83、491.86±44.61、204.84±70.19.将结节PEI值和结节旁肝组织PEI值对比,发现9个RN与邻近肝实质差异无统计学意义(t=-5.30, P=0.06), MRP图像的动脉期和门脉期RN均呈等信号;DN较邻近肝实质低,并有统计学意义(t=-3.64, P=0.02),DN的血流灌注曲线于动脉后期较邻近肝实质下降,MRP图像动脉期呈等信号,门脉期为低信号.10个早期HCC中4个结节表现为低灌注,PEI值低于邻近肝实质,动脉期呈稍低信号,门脉期为等信号;6个早期HCC显示为稍高灌注,PEI值稍高于邻近肝实质,动脉期为稍高信号,门脉期呈稍低信号.5个HCC呈典型的动脉期明显强化、门脉期呈相对低信号,结节灌注曲线动脉段较邻近肝实质有明显抬高,结节较邻近肝实质的PEI明显增大,差异有统计学意义(t=3.74,P=0.02).结论 MRP能反映HCC癌前病变结节演变过程中血流的改变,HCC的血流灌注量较邻近肝实质明显增多;DN的血流灌注量较邻近肝实质减少.
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