【摘要】 目的:探讨磁共振动态增强血管成像(DCE-MRA)对显示肝癌供血血管的价值。方法:41例肝癌患者行磁共振动态增强检查并采用动脉期最大信号强度投影(MIP)技术重建肝动脉血管,增强扫描原始图像观察肿瘤部位、大小、类型,重建血管图像观察肿瘤责任血管显示情况、肝动脉有无变异起源及有无寄生血管参与肿瘤供血,并与常规DSA进行对照,同时观察有无肝动脉-门静脉漏的发生。结果:所有患者均清晰显示由肿瘤的解剖信息,其中巨块型21例,巨块结节型8例,多发结节型6例,弥漫型7例。32例患者显示肿瘤主要由规则血管供血,并显示血管起源、数量,并不同程度显示了肿瘤区肝动脉血管受侵犯、血管断续、肿瘤染色等征象,与DSA显示完全相同。DCE-MRA显示7例患者为变异供血,并显示血管变异类型,9例巨块型和巨块结节型肝癌显示有寄生血管参与供血,3例患者动脉期轴面图像显示了肝动脉-门静脉漏。DSA显示变异型血供8例,寄生血管参与供血21例。结论:DCE-MRA及肝动脉重建技术能很好地显示肿瘤规则供血血管及血管变异情况,并能发现肝动脉-门静脉漏,对手术方法的选择、规范化治疗及提高疗效有重要作用,在细小的寄生血管显示上不及DSA。更多还原

【Abstract】 Objective:To probe into the values of dynamic contrast enhanced MR angiography(DCE-MRA)revealing the supplying blood vessels in primary hepatocellular carcinoma(HCC).Methods:41 patients with HCC underwent DCEMRA examination followed by maximum intensity projection(MIP)for reconstruction of tumor supplying arteries.We observed the following manifestations on MIP images:display quality of tumor supplying vessels,variations of origin of hepatic artery,parasitic arterial supplies and hepatic artery-portal vein fistulas.All results were documented and compared with those with DSA.Results:The anatomical information of tumors in all patients was clearly revealed.The number and macroscopic types of HCC were classified as follows:mass-forming type 21 cases,mass-nodular type 8 cases,nodular type 6 cases and confluent multinodular 8 cases.MIP clearly revealed the regular blood supply in 32 patents.It also revealed the origins and amount of supply vessels,invasions to the hepatic artery branches and tumor staining.The findings on MIP were the same on DSA.DCE-MRA revealed of variant blood supplies and their variation types in 7 patients.There were parasitic arterial supplies in 9 patients with mass-forming type and mass-nodular HCC.Arteriovenous fistulas between hepatic artery and portal vein were seen in three patients.While on DSA,8 patients had variant blood supplies and 21 patients had parasitic blood supplies.Conclusion:DCE-MRA with hepatic arterial MIP reconstruction is able to fully reveal the regular blood supply vessels of HCC tumors and their variations.It also can clearly display the hepatic artery-portal vein fistulas.Thus,DCEMRA can play an important role in choosing operation approaches,standardizing treatment planning and improving curative effects.However,it reveals less fine parasitic vessels than DSA does.更多还原