Small Hepatocellular Carcinoma (SHCC): The Correlation Of MR Signal Characteristics In Multiphase Enhancement Scan With Blood Supply And Pathological Grade

Objective: To analyse the signal change characteristics of small hepatocellularcarcinoma(SHCC) in MR enhanced multiphase scan, explore the relationship among MRsignal change,blood supply types and pathological grades, and improve the level ofpreoperative diagnosis of SHCC, and predicting the malignant degree.Materials and methods:93lesions of small hepatocellular carcinoma(SHCC) in90patients confirmed by surgery pathology were selected as the research object. In thesepatients74were male and16were female,aged25to84(mean54.6years old).All patientswere preoperatively on T2WI with respiratory triggering fat suppression fast spinecho,T1WI(using the breathless echo interference two-phase gradient echo),collectingsmall hepatocellular carcinoma of b value is1000focal nodules DWI signal can,and theliver volume ultrafast3D imaging(LAVA) for multi phase enhancement scan sequence,inaxial or coronal. The signal change characteristics in MR enhanced multiphase scan ofthese lesions were measured and recorded,made from contrast curves,The curves weredivided into four types:flow type,platform type,single phase type and the lack of bloodsupply type, analyzing the correlation of MR signal characteristics in multiphaseenhancement scan with blood supply and pathological grade.Calculated the peak contrastenhancement ratio (pCER) of SHCC [pCER=(SIenhancement-SIinitial)/SIinitial*100).To domultiple linear regression analysis by the patient’s ender,age,strengthening curve types andthe peak contrast enhancement ratio (pCER) of SHCC,P <0.05for the difference wasstatistically significant.Results:1.The pathological grade of small hepatocellular carcinoma nodules inoutflow enhancement curve was mostly poorly differentiated,platform type was mostly characterized by differentiation,single-phase type was mostly characterized by highdifferentiation (P<0.05),lack of blood type had no statistical significance.2.The higher thelesions of DWI signals can,the pathological grade was more tend to be poorlydifferentiated.3. If the peak contrast enhancement ratio (pCER) of SHCC in arterial phasewas higher and the peak contrast enhancement ratio (pCER) of SHCC in portal venousphase was lower,the malignant degrees to be more poorly differentiated(p<0.05); the peakcontrast enhancement ratio (pCER) of SHCC in delay phase had no statisticalsignificance.4. In the present study(age range25-84years, mean54.6years old),thesmaller the age was,the peak contrast enhancement ratio (pCER) of SHCC in arterial phasewas relatively higher,and pathological grade was tend to lower differentiation (P<0.05);and the peak contrast enhancement ratio (pCER) of SHCC in portal venous phase or indelayed phase and the age had no statistical significance;the peak contrast enhancementratio (pCER) of SHCC in all phases and the gender had no statistical significance.Conclusion:(1) The signal change characteristics of small hepatocellularcarcinoma(SHCC) in MR enhanced multiphase scan is associated with the characteristicsof the blood supply of tumors;(2)The signal change characteristics of small hepatocellularcarcinoma(SHCC) in MR enhanced multiphase scan, DWI signal，the peak contrastenhancement ratio and age have a certain correlation with pathological grades, and theycan be expected to predict the malignant degree.