【摘要】 目的探讨T1高分辨力各相同容积激发序列(e-THRIVE)动态增强并动脉期血管重建显示肝癌供血血管的价值。方法 2007年2月至2012年8月河南省商丘市第一人民医院收治41例肝癌患者,均行磁共振e-THRIVE序列动态增强检查并动脉期最大信号强度投影(MIP)重建肝动脉血管,e-THRIVE横断位图像观察肿瘤部位、大小、类型。重建血管图像,观察肿瘤血管显示:血管的起源、走行、数量,有无变异、寄生血管供血,并与常规血管造影对照。结果所有患者均清晰地显示肿瘤的解剖信息,其中巨块型21例、巨块结节型8例、多发结节型6例、弥漫型8例。32例患者显示肿瘤主要供血血管为规则供血,并显示血管起源、数量,并不同程度地显示了肿瘤区肝动脉血管受侵犯、血管断续、肿瘤染色征象,与数字减影血管造影(DSA)显示相似。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。与DSA相对照,显示了变异型血供7/8例,寄生型血供9/21例。结论 e-THRIVE动态增强并肝动脉重建能很好地显示肿瘤规则供血血管及血管变异情况,对手术方法的选择、规范化治疗、提高疗效有重要的作用,在细小的寄生血管显示上有待提高。更多还原

【Abstract】 Objective To evaluate the value of enhanced T1 high-resolution isotropic volume examination( e-THRIVE) combined with revascularization of arterial phase blood vessel on revealing liver cancer blood-supply vessels. Methods From February 2007 to August 2012,41 liver cancer patients were treated in Shangqiu First People’s Hospital. Magnetic resonance e-THRIVE sequence dynamic enhancement inspection was carried out to observe the location,size and type of tumor. Arterial phase maximum intensity projection( MIP) was performed to revascularize hepatic arteries and observe the tumor vessels,the source,shape and quantity of vessels,the variation if necessary and the blood supply of parasitic vessels. The results were compared with routine angiography. Results The anatomic structure of tumors was clearly revealed in all patients. There were 21 patients with massive liver cancer,8 with massive-nodule liver cancer,6 with multiple nodular liver cancer,and 8 with diffuse type liver cancer. In 32 patients,main blood supply came from normal vessels,and the source and quantity of vessels,and the signs that vessels in tumor area were invaded and interrupted and that tumor was dyed were revealed to some extent. The result was similar to digital subtraction angiography( DSA). Variant blood supply and variation type of blood vessels were seen in7 patients. Parasitic vessels participated in blood supply in 9 patients with massive & massive-nodule liver cancer. Compared with DSA,7 /8 patients suffered from variant blood supply and 9 /21 patients suffered from parasitic blood supply. Conclusions The e-THRIVE combined with revascularization of hepatic artery can fully reveal the regular blood supply vessels of tumor and the vessel variation,which plays an important role in choosing operation method,standardizing treatment and improving curative effect. However,it has limitations on revealing fine parasitic vessels.更多还原