Imaging Study Of Growth Characteristics Of Hepatic Aveolar Echinococcosis In Children

Purpose:CT,MR diffusion weighted imaging(DWI)and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)were used to evaluate the characteristics of hepatic alveolar hydatid disease(HAE)in children,to investigate the growth characteristics of HAE in children.Methods:51 cases of padiatric patients with HAE from June 2011 to October 2016 were diagnosed from university affiliated hospital,and all the patients?14 years old.All patients underwent abdominal CT scan and three phase enhancement,and MR-DWI and THRIVE dynamic enhancement sequences were performed in 20 patients.Analysis of routine imaging characteristics of lesions,PNM classification,extrahepatic metastasis characteristics,etc.To observe the signal intensity and continuity of peripheral zone on the DWI images of HAE lesions and the lesion enhancement characteristics of DCE-MRI.Measuring the ADC value and drawing the time intensity curve(TIC)of peripheral zone,the solid part of lesion and normal liver parenchyma to obtain semi quantitative parameters of maximum enhancement(ME),the maximum relative enhancement(MRE),wash in rate(WIR),time to peak(TTP)through post-processing workstation.Comparison of parameter differences between groups.Results:51 cases of padiatric patients with HAE PNM classification: P1N0 in 4 cases,P2N0 in 5 cases,P3N0 in 2 cases,P4N0 in 4 cases,P1N1 in 1 cases,P2N1 in 7 cases,P3N1 in 7 cases,P4N1 in 6 cases,M1 in 15 cases(P2N1M1 in 5 cases,P3N0M1 in 2 cases,P3N1M1 in 1 cases,P4N1M1 in 7 cases.5 cases lesions(9.8%)in P1,17 cases(33.3%)in P2,12 cases(23.5%)in P3,17 cases(33.3%)in P4.17 cases(33.3%)in N0,34 cases(66.7%)in N1.2 cases of single parts,32 cases of multiple parts,including the diaphragm in 14 cases,14 cases of portal area lymph nodes,right adrenal gland 9 cases.36 cases(70.6%)in M0,15 cases(29.4%)in M1: 7 cases of single parts,8 cases of multiple parts,Distant lymph nodes in 7 cases,3 cases of brain,vertebral body in 1 case.DWI image features: P1 lesions in 4 cases,showing a complete high signal of the peripheral zone or lesions as a whole nodular high signal.P2 lesions in 7 cases,P3 lesions in the case of,P2,P3 lesions with a continuous peripheral zone,still high signal.P4 lesions in 6 cases,the continuity of the continuity of the peripheral zone of the interruption and signal reduction,P2~P4 lesions of the liver edge region no significant signal.HAE solid portion of the tumor,liver tissue,peripheral zone with ADC values decreased,respectively,(1.57�0.14),(1.41�0.11),(1.07�0.12)�10-3mm2/s with statistical significance were statistically significant(F=147.647,P <0.001),statistically significant differences between the two groups(P < 0.05).DCE-MRI TIC parameters: In addition to peripheral zone and peripheral liver parenchyma TTP is no statistical significance(P = 0.891),solid part,peripheral zone,peripheral liver parenchyma ME,WIR,TTP,and MER comparative differences are statistically significant(P < 0.05).Conlusion:(1)Padiatric HAE with rapid growth,late stage,involving wide range,is given priority to with direct spread,lymph node metastasis.(2)To a certain extent,DWI images and ADC values evaluated the proliferative activity of the lesion.(3)The semi quantitative parameters of DCE-MRI reflect the hemodynamic characteristics of HAE and help to assess the microcirculation,blood perfusion and invasion extent of the marginal zone.