目的 探讨MRI连续动态增强扫描 对肝细胞癌的价值，提高肝细胞癌诊断符 合率。方法 39例经组织学或临床证实的 肝细胞癌患者同时行CT平扫，多期增强扫 描和MRI平扫，连续动态增强扫描。观察 连续动态增强肿瘤表现出的强化模式；在 连续动态增强扫描MRI，绘制肿瘤、主动 脉、门静脉及肝组织的时间-信号强度曲 线，并重建各期动态图像。对2种增强所 表现的良、恶性特征进行分类、计数和比 较。结果 在39例肝细胞癌的连续动态增 强扫描时间-信号强度曲线类型，速升速 降型27例、速升平缓降(或台)型6例、缓 升下降型5例、缓慢上升型1例；多期增强 的强化模式，动脉期强化、门静脉期及 延迟期密度(信号)减低20例；动脉期强 化、门静脉期及延迟期密度(信号)不减低 5例，动脉期不强化、门静脉及延迟期强 化4例；动脉期不强化、门静脉期及延迟 期密度(信号)低于肝组织10例。MRI连续 动态增强扫描表现出的恶性征象明显高于 多期动态扫描的强化模式(χ2 =37.375， P＜0.000)。在肿瘤的综合诊断中，诊断 等级定为肯定良性、可能良性、不能确 定、可能肝细胞癌和肯定肝细胞癌，连续 动态增强扫描等级例数相应为1、2、3、 5、28；多期动态扫描分别为2、3、6、 7、21，连续动态增强扫描的诊断符合率 明显高于多期增强扫描(χ2 =49.259，P ＜0.000)。结论 MRI连续动态增强扫描能 获得组织完整的对比剂流入和廓清状态， 与多期增强比较，有利于对肿瘤个性化分 析，对肝细胞癌诊断符合率高，具有推广 价值。

Objective To evaluate diagnosing values of continuous MRI during enhancement to hepatocelllular carcinoma and promote diagnosing coincident rate. Methods 39 patients with hepatocellular carcinoma confirmed by histology or clinical were performed CT plain scan, multiple phase contrast enhanced scan and MRI plain scan, continuous dynamic enhanced scanning. Intensifying models of tumors in dynamic enhancement were observed. From continuous dynamic enhancement of MRI, timesignal intensity curves of tumor, aorta, portal vein and liver tissue were drawn and dynamic multi-imaging were reconstructed. Benign and malignant manifestations of both enhancing ways were classified, counted and compared. Results Types of time-signal intensity curves in continuous dynamic enhancement of MRI were 27 rapidly ascend and rapidly descend, 6 rapidly ascend and slowly descend (plane), 5 slowly ascend and descend, 1 slowly ascend. Model of multi-phase enhancing were 20 intensity in arterial phase, no intensity in portal and delay phase, 5 intensity in 3 phases, 4 no intensity in arterial phase, intensity in portal and delay phases, 10 no intensity in 3 phases. Continuous dynamic enhancing MRI showed more malignant characters of tumors than routine multi-phases CT enhancing (χ2 =37.375, P＜0.000). Grade of tumor were classified as affirmative benign, possible benign, uncertain possible malignant, affirmative malignant by synthetic diagnosis. Accordingly, number of cases in continuous dynamic enhancing MRI ordinally were 1, 2, 3, 5, 28 and number of cases in multi-phase enhancing MRI ordinally were 2, 3, 6, 7, 21. Continuous dynamic enhancing MRI had higher diagnosing coincident rate than multi-phase enhancing CT(χ2 =49.259, P＜0.000). Conclusion Continuous dynamic enhancing MRI could shows full intensifying process of contrast medium. Compared with multi-phase enhancement, It is able to analyse severally tumor and promote diagnosing coincident rate of hepatocellular carcinoma. So continuous dynamic enhancing MRI is a way of deserving generalization.