MSCT联合增强MRI鉴别诊断肝脏局灶性结节性增生与肝细胞癌价值研究*

doi:10.3969/j.issn.1672-5069.2026.02.035

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (2): 301-304.doi: 10.3969/j.issn.1672-5069.2026.02.035

MSCT联合增强MRI鉴别诊断肝脏局灶性结节性增生与肝细胞癌价值研究^*

石国富, 朱志韬, 张苏波, 金怀玉

222023 江苏省连云港市南京医科大学康达学院附属连云港第二人民医院医学影像科

收稿日期:2025-03-19 出版日期:2026-03-10 发布日期:2026-03-13
通讯作者: 金怀玉,E-mail:272403649@qq.com
作者简介:石国富,男,54岁,大学本科,副主任医师。E-mail:13775443638@163.com
基金资助:
^*江苏省连云港市卫生健康委面上科研项目(编号:2023025)

MSCT and enhanced MRI in the differential diagnosis of focal nodular hyperplasia and hepatocellular carcinoma: Analysis of 108 cases

Shi Guofu, Zhu Zhitao, Zhang Supo, et al

Department of Radiology, Second People's Hospital, Affiliated to Nanjing Medical University Kangda College, Lianyungang 222023, Jiangsu Province, China

Received:2025-03-19 Online:2026-03-10 Published:2026-03-13

摘要/Abstract

摘要： 目的探讨多层螺旋计算机断层扫描(MSCT)联合增强磁共振成像(MRI)鉴别诊断肝脏局灶性结节性增生(FNH)与肝细胞癌(HCC)的价值。方法 2016年1月～2024年8月我院收治的108例肝脏占位性病变患者,均接受MSCT和增强MRI扫描检查。结果经病理学检查,本组诊断FNH患者41例,病灶直径为(3.3±0.9)cm,和HCC患者67例,病灶直径为(2.9±0.9)cm; HCC组病灶MR动脉增强分数(AEF)和病灶/肝组织AEF比值分别为(67.7±7.6)和(1.4±0.2),显著高于FNH病灶【分别为(53.7±4.5)和(1.2±0.1),P＜0.05】;HCC病灶T1WI呈低信号占比为83.6%,显著高于FNH病灶的58.5%(P＜0.05),ADC呈低信号占比为94.0%,显著高于FNH病灶的14.6%(P＜0.05),强化呈快进快出占比为91.0%,显著高于FNH病灶的2.4%(P＜0.05);HCC病灶相对ADC值为(0.8±0.2),显著低于FNH病灶【(1.1±0.2),P＜0.05】。结论 MSCT联合增强MRI可鉴别诊断FNH与HCC,可帮助临床医生做出初步判断。

关键词: 肝细胞癌, 肝脏局灶性结节性增生, 多层螺旋计算机断层扫描, 增强磁共振成像, 诊断

Abstract: Objective The aim of this study was to investigate imaging feature of multi-slice spiral computed tomography (MSCT) and enhanced magnetic resonance imaging (MRI) in the differential diagnosis of focal nodular hyperplasia (FNH) of liver and hepatocellular carcinoma (HCC). Methods A total of 108 patients with intrahepatic space-occupying lesions (SOL) were encountered in our hospital between January 2016 and August 2024, and all underwent dual-source force 256-slice spiral CT and enhanced MAGNETOM Spectra 3.0 T MRI scans. Results Of 108 patients with SOL in our series, the histo-pathological examination proved FNH in 41 cases, with lesion diameter of (3.3±0.9)cm, and HCC in 67 cases, with diameter of (2.9±0.9)cm; MR arterial enhancement fractional (AEF) and lesion/liver AEF ratio in HCC were (67.7±7.6) and (1.4±0.2), both significantly higher than [(53.7±4.5) and (1.2±0.1), respectively, P＜0.05] in FNH; percentage of low signals on T1WI in HCC was 83.6%, much higher than 58.5%(P＜0.05), percentage of low signals on apparent diffusion coefficient (ADC) was 94.0%, much higher than 14.6%(P＜0.05), and percentage of fast in and fast out style of enhancement was 91.0%, much higher than 2.4%(P＜0.05) in FNH; relative ADC in HCC was (0.8±0.2), much lower than [(1.1±0.2), P＜0.05] in FNH. Conclusion Features of MSCT and enhanced MRI could help clinicians make differential diagnosis of FNH from HCC, which might be very important in clinical practice.

Key words: Hepatocellular carcinoma, Focal nodular hyperplasia, Multi-slice spiral computed tomography, Enhanced magnetic resonance imaging, Differential diagnosis

石国富, 朱志韬, 张苏波, 金怀玉. MSCT联合增强MRI鉴别诊断肝脏局灶性结节性增生与肝细胞癌价值研究^*[J]. 实用肝脏病杂志, 2026, 29(2): 301-304.

Shi Guofu, Zhu Zhitao, Zhang Supo, et al. MSCT and enhanced MRI in the differential diagnosis of focal nodular hyperplasia and hepatocellular carcinoma: Analysis of 108 cases[J]. Journal of Practical Hepatology, 2026, 29(2): 301-304.

参考文献

[1] 谭玉英,张鑫,张娟子,等. MRI联合血清GPC3水平鉴别肝脏结节性增生病灶临床应用价值研究. 实用肝脏病杂志,2022,25(1):88-91.
[2] Li Z, Yang G, Wang R, et al. γ-cyclodextrin metal-organic framework as a carrier to deliver triptolide for the treatment of hepatocellular carcinoma. Drug Deliv Transl Res, 2022,12(5):1096-1104.
[3] Ge XH, Zhang JF. CT-value (delta hu and ct-value ratio) in differential diagnosis of small hepatocellular carcinoma from focal nodular hyperplasia. Int J Radiat Res,2020,18(4):641-646.
[4] 隋虎,毛佳,陈露,等. CT定量参数鉴别诊断肝局灶性结节增生与肝细胞癌的价值研究. 实用肝脏病杂志,2024,27(4):611-614.
[5] Wang J, Tang S, Mao Y, et al. Radiomics analysis of contrast-enhanced CT for staging liver fibrosis: an update for image biomarker. Hepatol Int, 2022,16(3):627-639.
[6] 魏野,汪施妤,葛高华,等. CT增强扫描与磁共振检查诊断肝血管瘤和肝细胞癌价值分析. 实用肝脏病杂志,2024,27(2):279-282.
[7] Liu D, Qiao Z, Xu L, et al. Gd-EOB-DTPA enhanced MRI features of liver hemangiomatosis coexistent with GCH. Curr Med Imagin, 2022,18(13):1390-1395.
[8] 中华人民共和国卫生和计划生育委员会医政医管局. 原发性肝癌诊疗规范(2017年版). 中华消化外科杂志,2017,16(7):635-647.
[9] 中国抗癌协会肝癌专业委员会(CSLC),中国抗癌协会临床肿瘤学协作专业委员会(CSCO),中华医学会肝病学分会肝癌学组. 原发性肝癌规范化诊治的专家共识. 肝脏,2009,14 (3):237-245.
[10] Rousseau C, Ronot M, Vilgrain V, et al. Optimal visualization of focal nodular hyperplasia: quantitative and qualitative evaluation of single and multiphasic arterial phase acquisition at 1.5 T MR imaging. Abdom Radiol (NY), 2016, 41(5):990-1000.
[11] 刘宜,张晓辉,卢文献,等. 多层螺旋CT和MRI对原发性肝癌定性诊断及治疗方案指导的价值研究. 中国CT和MRI杂志,2022,20(2):93-95.
[12] 刘新爱,任月勤. 应用DCE-MSCT扫描鉴别诊断小肝癌及肝硬化再生结节的可行性研究. 中国CT和MRI杂志,2022,20(3):77-79.
[13] Bastati N, Beer L, Ba-Ssalamah A, et al. Gadoxetic acid-enhanced MRI-derived functional liver imaging score (FLIS) and spleen diameter predict outcomes in ACLD. J Hepatol, 2022, 77(4):1005-1013.
[14] Winther H, Hundt C, Ringe KI, et al. A 3D deep neural network for liver volumetry in 3T contrast-enhanced MRI. Rofo, 2021,193(3):305-314.
[15] Suh CH, Kim KW, Kim GY, et al. The diagnostic value of Gd-EOB-DTPA-MRI for the diagnosis of focal nodular hyperplasia: a systematic review and meta-analysis. Eur Radiol,2015, 25(4):950-960.
[16] 梁磊,李迎冬,高杨,等. 肝脏局灶性结节性增生患者临床特征及影像学表现. 实用肝脏病杂志,2024,27(4):615-618.
[17] 刘佳,徐鹏举,张珍. 肝脏局灶性结节增生动态增强MRI征象与病灶大小的关系. 中国CT和MRI杂志,2024,22(3):134-136.
[18] Ota T, Onishi H, Fukui H,et al. Prediction models for differentiating benign from malignant liver lesions based on multiparametric dual-energy non-contrast CT. Eur Radiol, 2025,35(3):1361-1377.
[19] Gai Q, Li X, Li N, et al. Clinical significance of multi-slice spiral CT, MRI combined with gastric contrast-enhanced ultrasonography in the diagnosis of T staging of gastric cancer. Clin Transl Oncol, 2021,23(10):2036-2045.
[20] Varigonda M, Yarlagadda J, Chetana Naga Sai T,et al. The role of diffusion-weighted MRI in correlation with contrast-enhanced MRI and histopathology in the evaluation of focal liver lesions. Cureus, 2024, 16(10):e71261.

MSCT联合增强MRI鉴别诊断肝脏局灶性结节性增生与肝细胞癌价值研究^*

MSCT and enhanced MRI in the differential diagnosis of focal nodular hyperplasia and hepatocellular carcinoma: Analysis of 108 cases

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