| Part1 Dynamic enhancement mode of HCC: comparison of Gd-EOB-DTPA dynamic enhancement MRI and CTObjective: Based on the degree of differentiation of tumor cells and the size of solid tumors(≤2cm),the dynamic enhancement mode of Gd-EOB-DTPA enhanced MRI and CT examination on HCC and whether there is any difference is evaluated.At the same time,it analyzes the diagnostic capabilities of Gd-EOB-DTPA enhanced MRI and enhanced CT for atypical enhancement patterns of HCC,aiming to improve the accuracy of preoperative diagnosis of liver cancer and predict the possibility of its malignancy.Methods : A total of 67 lesions in 58 HCC patients from July 2017 to October 2020 were retrospectively analyzed.Gd-EOB-DTPA dynamic enhanced MRI and dynamic enhanced CT scanning were performed before surgery.HCC patients can be divided into highly differentiated group(18 cases)and moderately or poorly differentiated group(49 cases)based on the pathological results of the operation.These patients were also divided into two groups(≤2cm and >2cm)according the tumor diameter.The enhancement mode of HCC is including typical and atypical groups,and then Based on the degree of tumor differentiation and size,the difference of the dynamic enhancement mode and the diagnostic ability of HCC between Gd-EOB-DTPA MRI and CT was evaluated.Results: For the typical enhancement pattern of moderately or poorly differentiated HCC,GD-EOB-DTPA enhanced MRI examination showed better than enhanced CT examination(P = 0.009),but for the typical enhancement pattern of highly differentiated HCC,there was no statistically significant difference between GD-EOB-DTPA enhanced MRI and enhanced CT(P =0.180);and for both moderately and poorly differentiated HCC,the typical enhancement pattern of both examinations was superior to that of highly differentiated HCC(EOB-MRI:P =0.030;CT: P = 0.041).All showed better than well-differentiated HCC.For HCC with diameter less than 2cm,GD-EOBDTPA enhanced MRI is more sensitive than enhanced CT to describe the typical enhancement pattern of HCC than enhanced CT(P = 0.002),but between the two examinations on the typical enhancement pattern of HCC with diameter >2cm,there is no statistical significance(P =0.217).The enhanced CT examination only shows the typical enhancement pattern more sensitively of HCC with diameter >bigger than 2cm(P =0.018),In the group of different sizes,the display of typical enhancement mode was not statistically significant(P =0.789)in MRI and CT.For HCC with atypical enhancement mode,hepatobiliary phase images can be used to improve the diagnostic efficiency of HCC,but there is no significant difference(P >0.05).Conclusion :The typical enhancement mode is displayed better on GD-EOB-DTPA enhanced MRI than on in the group of moderately or poorly differentiated HCC.For HCC with diameter less than 2cm,GD-EOB-DTPA enhanced MRI can show the typical enhancement pattern better than CT.For HCC with atypical enhancement mode,hepatobiliary specific phase can improve the diagnostic accuracy of MRI.Prat 2 GD-EOB-DTPA MRI and CT dynamic enhancement to evaluate the blood supply of HCC and pathological control analysisObjective:The characteristics of blood supply were discussed based on GD-EOB-DTPA dynamic enhancement MRI and dynamic enhancement CT,and compared with pathological results.The purpose of this study was to analyze the difference of blood supply between the two methods in dynamic stages.The clinical application value of HCC cell differentiation was predicted by arterial blood supply and hepatobiliary phase images.Methods:Retrospective analysis of the preoperative GD-EOB-DTPA dynamic enhancement MRI and dynamic enhancement CT image data of 58 patients confirmed by surgical pathology from July 2017 to October 2020,A total of 67 lesions.According to the pathological results of surgery,HCC patients can be divided into well-differentiated group(18),moderately-differentiated group(35)and poorly-differentiated group(14).According to the three-stage dynamic enhancement images HCC the arterial phase enhancement,portal phase decline and delayed phase decline were observed;at the same time,the dynamic three-phase HCC-liver contrast(C_M)and hepatobiliary phase C_M and contrast enhancement ratio(CER)were calculated,and compared with pathological results.Results:The study found that EOB-MRI examination and CT dynamic enhancement were not statistically significant in the detection of HCC in arterial phase enhancement(P=0.069),hypointensity on portal venous phase was seen more frequently with EOB-MRI than with CT(P=0.005),hypointensity on delayed phase was seen more frequently with EOB-MRI than with CT(P=0.003).The results also showed that the CT arterial phase C_M was greater than EOB-MRI(P=0.018),while the EOB-MRI delayed phase C_M was much less than CT(P<0.001).In addition,compared with the C_M value in the arterial phase and the C_M value in the hepatobiliary phase,the correlation between CER in the hepatobiliary phase and the degree of HCC differentiation was better(r=0.367,P=0.001).conclusion:For the display of HCC blood supply,dynamic enhanced CT in the arterial phase is better than EOB-MRI,and EOB-MRI in the delayed phase is better than dynamic enhanced CT;the greater the relative enhancement rate in the hepatobiliary phase,the better the degree of HCC differentiation. |
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