目的:探讨三维快速扰相梯度回波(3D-FSPGR)序列MRI动态增强扫描和扩散加权成像(DWI)对肝内小结节病变的诊断价值。方法:对56例经US或CT检查发现肝内小结节的患者行常规MRI平扫、3D-FSPGR动态增强及DWI检查(SE-EPI技术,b值分别为0和800 s/mm2)。对比分析3D-FSPGR三期增强扫描(A组)、DWI(B组)及这2种方法联合应用(C组)在结节检出和定性诊断方面的价值。结果:在结节检出方面:A组检出61个结节,B组检出49个,C组检出72个,3组间差异有极显著性意义(χ2=27.72,P<0.01);A组与B组比较,差异无显著性意义(χ2=5.54,P>0.05);A组、B组分别与C组比较,差异均有显著性意义(χ2值分别为11.91和27.37,P<0.01)。在结节的定性诊断方面:在取得临床或病理证实的52个病例中,A组诊断正确36例(69.2%),C组为47例(90.4%),2组间差异有显著性意义(χ2=7.21,P<0.05)。结论:联合应用3D-FSPGR动态增强扫描和DWI对肝内小结节病灶的检出和诊断具有重要的临床应用价值。 Objective: To investigate the diagnostic value of three-dimensional fast scintillation gradient echo (3D-FSPGR) sequence dynamic contrast-enhanced MRI and diffusion weighted imaging (DWI) in the diagnosis of small intrahepatic nodules. Methods: Fifty-six patients with small intrahepatic nodules detected by US or CT underwent plain MRI, 3D-FSPGR dynamic contrast enhancement and DWI examination (SE-EPI, b values ​​were 0 and 800 s / mm2 respectively). The value of 3D-FSPGR triple enhanced scan (group A), DWI (group B) and combination of these two methods (group C) in the detection and qualitative diagnosis of nodules were compared and analyzed. Results: In nodule detection, 61 nodules were detected in group A, 49 in group B and 72 in group C. There were significant differences among the three groups (χ2 = 27.72, P <0.01) ; There was no significant difference between group A and group B (χ2 = 5.54, P> 0.05). There was significant difference between group A and group B and group C (χ2 = 11.91 and 27.37, P <0.01). In qualitative diagnosis of nodules, among the 52 cases with clinical or pathological findings, 36 cases (69.2%) were correctly diagnosed in group A and 47 cases (90.4%) in group C, with significant difference between the two groups χ2 = 7.21, P <0.05). Conclusion: Combined application of 3D-FSPGR dynamic contrast-enhanced scanning and DWI has important clinical value in the detection and diagnosis of small intrahepatic nodules.