Clinical value of susceptibility-weighted imaging for studying the multi-step hepatocarcinogenic process of cirrhotic liver nodules
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摘要:
肝癌早期发现,早期治疗,明显提高5年生存率。肝硬化患者,绝大部分均经历肝硬化结节多步癌变的过程,即由再生结节发展为异型增生结节,其中高分化异型增生结节发展为癌变结节后(早期肝癌),再发展为小肝癌,小肝癌最后发展成进展期或晚期肝癌。上述结节的一系列变化过程中,其结节内内源性铁逐步廓清,本文重点介绍利用磁共振磁敏感加权成像(SWI)技术观察结节中内源性铁变化情况,同时结合常规MR T2WI、弥散加权成像(DWI)和动态增强等技术,提高识别肝硬化背景下的癌变/早期肝癌结节能力,从而对进一步提高早期小肝癌的诊疗,具有更重要的临床意义。
Abstract:Early detection, diagnosis, and effective treatment markedly improves the 5-year survival rate of patients with hepatocellular carcinoma (HCC) .Initiation of the multi-step hepatocarcinogenesis process often involves a cirrhotic nodule.After the regenerative nodule develops into a dysplastic nodule (DN) , it continues to advance from a low degree DN to a high degree DN.The high degree DN may then further develop to early HCC/small HCC or even progressed/advanced HCC.Previous studies have shown that endogenous iron within the nodule can inhibit or resolve the hepatocarcinogenic process.This review discusses the clinical utility of magnetic resonance (MR) susceptibility-weighted imaging for detecting and monitoring changes in nodular iron and the implications of this technology when combined with T2WI, diffusion weighted imaging, and dynamic contrast enhancement for improving clinical decision-making, thereby enhancing diagnostic efficacy for early HCC/small HCC in the cirrhotic background.
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Key words:
- liver cirrhosis /
- carcinoma /
- hepatocellular /
- iron compounds
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