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[目的]探讨肝血管瘤周围肝实质灌注异常的MRI表现及其可能的发生机制。[方法]回顾分析73例肝血管瘤患者的MRI动态增强表现。使用GESigna1.5T超导型MRI扫描仪,全部患者均行SE序列T1WI、T2WI及动态增强扫描。瘤体大小采用门静脉期最大直径,强化速度根据动脉期病灶强化充填体积是否占肿瘤总体积的50%,分为快速强化和慢速强化。[结果]73例血管瘤出现异常高灌注17例(23.2%)。肝动脉期表现为楔形、节段性或分叶状强化;门静脉期信号略高于肝实质或与肝实质等信号,延迟期与肝实质等信号。快速强化型血管瘤出现肝实质灌注异常现象(HPD)的几率(76.4℅)大于慢速强化型(23.6℅)(P﹤0.01);小血管瘤(d≤2cm)出现HPD的几率与大血管瘤(d﹥2cm)无统计学差异(P﹤0.01)。[结论]肝血管瘤周围异常灌注易见于快速强化型血管瘤,且具有特征性的MRI表现,肝脏MRI动态增强扫描是诊断肝脏异常高灌注的有效方法。
[Objective] To investigate the MRI findings and its possible mechanism of abnormal hepatic parenchymal perfusion in hepatic hemangiomas. [Methods] The dynamic MRI findings of 73 patients with hepatic hemangioma were retrospectively analyzed. Using GESigna1.5T superconducting MRI scanner, all patients underwent SE sequence T1WI, T2WI and dynamic contrast-enhanced scan. Tumor size using the largest portal vein diameter, the rate of enhancement according to the arterial phase lesion enhancement fill volume accounted for 50% of the total tumor volume, divided into rapid strengthening and slow strengthening. [Results] There were 17 cases (23.2%) of abnormal angioma in 73 cases. Hepatic arterial phase manifested as wedge-shaped, segmental or lobulated enhancement; portal vein signal slightly higher than the liver parenchyma or liver and other signals, the signal of the delay and the liver parenchyma. The rate of HPD in fast-growing hemangiomas was higher (76.4%) than that in slow-intensified (23.6%) (P <0.01), and the incidence of HPD in small hemangiomas (d≤2 cm) Tumors (d> 2cm) had no statistical difference (P <0.01). [Conclusions] Abnormal perfusion around hepatic hemangioma is easily seen in rapidly enhanced hemangiomas with characteristic MRI manifestations. MRI dynamic contrast-enhanced scanning of liver is an effective method to diagnose abnormal liver perfusion.