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目的:探讨原发性肝癌不同分化程度、细胞类型的MRI图像特征、参数。方法:回顾性分析肝硬化再生结节27例、肝细胞癌75例81处病灶(高度分化15例,中度分化40例,低度分化26例)、肝内胆管癌20例的病理结果及MRI影像学数据,比较再生结节、肝细胞癌和肝内胆管癌之间,以及肝细胞癌各种组织分化程度之间的ADC值、强化程度差异。结果:常规MRI平扫结合LAVA可准确诊断大部分原发性肝癌病例。再生结节、肝细胞癌及肝内胆管癌ADC值均值的具有显著统计学差异(P<0.01);肝细胞癌高分化组、中分化组及低分化组ADC值均值均具有显著统计学差异(P<0.01),但中、低分化肝细胞癌ADC值均值的差异无实际临床意义;高分化肝细胞癌与肝内胆管癌ADC值均值的差异无统计学意义(P=0.27)。结论:常规MRI结合DWI、多期动态增强扫描有助于区分原发性肝癌各种组织分化程度及细胞类型。
Objective: To investigate the MRI features and parameters of different degrees of differentiation and cell types in primary liver cancer. Methods: Retrospective analysis of 27 cases of regenerative nodules of liver cirrhosis, 75 cases of hepatocellular carcinoma in 81 lesions (15 cases of highly differentiated, 40 cases of moderately differentiated, 26 cases of poorly differentiated) and 20 cases of intrahepatic cholangiocarcinoma MRI imaging data, comparing the regenerative nodules, hepatocellular carcinoma and intrahepatic cholangiocarcinoma, as well as between the degree of differentiation of hepatocellular carcinoma ADC value, the degree of enhancement difference. Results: Conventional MRI combined with LAVA can accurately diagnose most cases of primary liver cancer. The mean ADC values of regenerative nodules, hepatocellular carcinoma and intrahepatic cholangiocarcinoma were significantly different (P <0.01). The mean ADC values of well differentiated, moderately differentiated and poorly differentiated hepatocellular carcinoma were significantly different (P <0.01). However, there was no significant difference in mean ADC value between moderately and poorly differentiated hepatocellular carcinoma (P> 0.05). There was no significant difference in mean ADC value between well-differentiated hepatocellular carcinoma and intrahepatic cholangiocarcinoma (P = 0.27). Conclusion: Conventional MRI combined with DWI, multi-phase dynamic contrast-enhanced scan can help differentiate the degree of cell differentiation and cell types in primary liver cancer.