目的 探讨高场强MRI对于肝硬化 退变结节以及小肝癌诊断、见表诊断的临 床应用价值。方法 选择2014年1月至2016 年1月期间在我院就诊的18例共24个肝硬 化退变结节(DN)以及15例共26个小肝癌 (SHCC)患者的MRI图像作为研究资料，对 33例患者的MRI图像进行回顾性分析。结 果 在18例24个DN患者中，4个在同反相位 T1WI上呈现等信号，比例是16.67%，其余 20个呈稍高信号，比例为83.33%；在15例 26个SHCC患者中，6个(23.08%)在同相位 T1WI上呈稍高信号，另有20个(76.92%) 在同、反相位TlWI上呈低信号或等信号。 在T2WI上DN组患者的24个结节均呈现低 信号，而SHCC组的26个结节中，24个呈现 不均匀等信号、稍高信号或高信号，所占 比例是92.31%，仅2个在T2WI上呈现低信 号，比例为7.69%。在Gd-DTPA动态增强扫 描中，发现DN组中14例患者的15个DN是呈 缓升速降型的，比例为93.33%，其中13个 DN可发现不规则网状纤维隔强化，比例 86.67%，仅1个DN呈假包膜样强化；SHCC 组中14例患者24个SHCC是呈速升速降型 的，比例为92.31%，其中包膜强化有17 个，比例为70.83%。结论 高场强的MRI能 够有效的凸显肝硬化患者退变结节和早期 小肝癌的相关特征，从而做出诊断和见表 诊断，帮助临床提高诊断率，从而制定后 续治疗方案。

Objective To study the application value of high field MRI in the differential diagnosis of DN (dysplastic nodule) and SHCC (small hepatocellular carcinoma). Methods 18 cases (24 DN) and 15 cases (26 SHCC) treated from January 2014 to January 2016 in our hospital were selected. The MRI images were retrospectively analyzed. Results For 24 DN, there were 4 equi-signal cases in phase and opposed phase T1WI (16.67%) and 20 slightly high signal cases (83.33%), for 26 SHCC, there were 6 slightly high cases in phase T1WI (23.08%) including 3 low signal cases in opposed phase T1WI, there were 20 low signal or equi-signal cases in phase and opposed phase TlWI (76.92%). For 24 DN, there were 24 low signal cases on T2WIN, for 26 SHCC, there were 24 cases with heterogeneous equal signal, slightly high signal or high signal (92.31%) and 2 low signal cases on T2WI (7.69%). According to Gd-DTPA dynamic-enhanced scanning, DN group had 15 DN with slow rising and descending images (93.33%) including 13 DN with irregular reticular fiber reinforcement images (86.67%) and one DN with pseudocapsule reinforcement images; SHCC group had 24 SHCC with quick rising and descending images (92.31%) including 17 SHCC with enveloped reinforcement images (70.83%). Conclusion The high field MRI can efficiently reflect the clinical features of DN and early SHCC and make the differential diagnosis, which it is good to improve the diagnosis rate and determine the treatment schemes.