肝脏常见疾病的MR表现讲解课件.ppt

再生性大结节（RN） 右前叶下段结节，动脉期强化，门脉期呈等信号，肝胆特异期呈高信号 再生性大结节？退变结节？高分化肝癌？ 增生性（退变）结节（DN） 低级别DN、高级别DN T1W信号：高 低 T2W信号：等 高 增强动脉期血供：少 多 DWI弥散受限程度：低 高 T2W-FS T1W-FS 动脉期 门脉期 延迟期 高级别DN 肝 癌 MR表现 T1WI呈等低信号，T2WI呈偏高信号 肝癌的主要血供来自肝动脉，增强呈“快进快出”样改变 肿瘤较大可发生出血坏死 门脉癌栓；肝动脉-门静脉瘘 T1W-FS 预扫 动脉期 门脉期 延迟期 10min 肝胆特异期 延迟90min T2WI-FS 肝右后叶小肝癌 ADC图 同相位 反相位 DWI b值=800 肝右后叶小肝癌 T1WI-FS 预扫 动脉期 门脉期 延迟期 10min 肝胆特异期 延迟90min T2WI-FS 多中心型肝癌 ADC图 同相位 反相位 DWI b值=800 多中心型肝癌 T1WI-FS 预扫 动脉期 门脉期 延迟期 10min 肝胆特异期 延迟90min T2WI-FS 肝右叶肝癌并门脉癌栓 ADC图 同相位 反相位 DWI b值=800 肝右叶肝癌并门脉癌栓 肝转移瘤 是肝脏最常见的恶性肿瘤之一 转移途径： 邻近器官肿瘤的直接侵犯； 经肝门部淋巴结转移； 经门静脉转移； 经肝动脉转移 常见结肠癌、胰腺癌、其次乳腺癌、肺癌、肾癌、卵巢癌等 常为多发，少数单发 T1WI-FS 预扫 动脉期 门脉期 T2WI-FS 直肠癌肝转移 延迟期 10min 肝胆特异期 延迟90min ADC图 同相位 反相位 DWI b值=800 直肠癌肝转移 In the 3 slices shown, 3 separate lesions are identified (arrows), 2 within the left lobe and 1 within the right lobe. The lesions are slightly hyperintense relative to liver on T2 imaging. All 3 lesions show relatively uniform and avid enhancement on arterial-phase imaging with slight hyperintensity on portal-venous-phase imaging (not shown). Delayed hepatobiliary-phase images show hyperintensity of these lesions relative to the adjacent liver. The largest lesion (middle row) in the left lobe shows a classic central scar appearance and approximately matches the hyperintense central scar seen on T2-weighted imaging. A relatively large area of hypointensity is seen in the second lesion (top row), a pattern that is also commonly observed on delayed-phase imaging. Finally, 1 small lesion (bottom row) demonstrates a hyperintense rim that is often seen in smaller FNH. ?3个层面，3个病灶，左叶2个，右叶1个。T2呈稍高信号，动脉期明显、均匀强化，门脉期呈稍高信号，延迟20分钟病灶呈稍高信号。最大病灶呈典型的中央瘢痕，T2压脂瘢痕呈高信号；最小的病灶延迟呈高信号环，是较小FNH的常见表现。 The constellation of imaging findings, including delayed hepatobiliary-phase imaging, is diagnostic for FNH, particularly in an asymptomatic patient. No other lesion should be considered in the differential diagnosis. The use of optimized delayed he