目的:探讨磁敏感加权成像(SWI)在肝脏局灶性病变内部结构的显示能力及其鉴别诊断中的应用价值。方法:搜集18例经临床及影像证实肝脏病变包括血管畸形、肝细胞癌、转移瘤、血管瘤以及肝囊肿患者共25个肝局灶性病变行常规T1WI、T2WI及SWI扫描,并将其SWI图像与常规MRI序列进行比较。18例均同时行增强扫描,1例动静脉畸形同时行MRA检查,1例血管瘤动态增强后再次行SWI检查。结果:1例血管畸形SWI能较常规平扫、增强及3D MRA更清楚显示其异常静脉血管形态;4例肝细胞癌、3例胆管细胞癌及2例转移瘤,SWI均能显示病灶内瘤静脉及血液降解产物;5例肝血管瘤及3例肝囊肿,SWI均显示病灶呈均匀稍高信号,病灶较大者邻近静脉受压。结论:SWI在显示肝脏静脉性血管畸形、肿瘤相关静脉结构等方面优于常规MR序列,对肝脏局灶性病变有一定鉴别诊断价值,是研究肝脏局灶性病变内部结构的一种新的方法。
Objective: To investigate the value of susceptibility weighted imaging in the discovery and diagnosis of focal liver lesions.Methods: Eighteen patients with 25 focal liver lesions were collected,all of them were proved by clinic and imaging.It included liver vascular malformation(n=1),hepatocellular carcinoma(n=4),cholangiocellular carcinoma(n=3),metastatic tumor in liver(n=2),liver haemangioma(n=5),and liver cyst(n=3).MR imaging were performed with conventional T1WI,T2WI,SWI and dynamic Gd-DTPA contrast enhanced MRI.The SWI imagings were compared to conventional sequence imagings.3D MRA were performed in liver vascular malformation(n=1) and post-gadolinium enhanced SWI performed in one liver haemangioma.Results: In liver vascular malformation(n=1),SWI was better than conventional MRI and 3D MRA in discovering abnormal veins.SWI could discover tumor vascular structure and degradation products of blood in hepatocellular carcinoma(n=4),cholangiocellular carcinoma(n=3) and metastatic tumor in liver(n=2).SWI showed homogeneous slight hyper-signal in liver haemangioma(n=5) and liver cyst(n=3),and in comparatively large lesion of which the adjacent vein was compressed.Conclusion: SWI surpassed conventional MRI sequences in discovering liver venous vascular malformation and vascular structure in tumor.SWI is very helpful in differential diagnosis of focal liver lesions.It is a new approach to investigate the internal structures of focal liver lesions.