动态增强三维血管成像MR技术在腹部肿瘤诊断中的作用

Three-dimensional dynamic contrast-enhanced MR angiography in diagnosis of abdominal tumors

目的 探讨动态增强三维血管成像技术(3D CE MRA)在诊断腹部肿瘤中的价值。方法 26 例腹部良恶性肿瘤患者行常规MRI与3D CE MRA,对3D CE MRA病灶检出率、对比噪声比(CNR)进行比较,统计其肿瘤的动静脉显示率,并观察肿瘤不同增强时相的表现。结果 共41个病灶,在实质脏器37个病灶中,T2WI检出29 个,B超检出30 个,3DCE MRA动脉期检出34个,其病灶检出率高于T2WI和B超。肝内肿瘤CNR,T2WI为21±3.8,3D CE MRA动脉期为13±4.6(P<0.05),静脉期为19±3.3(P>0.05),延迟期为23±2.5(P<0.05)。肝外肿瘤CNR, T2WI为15±5.8,3DCE MRA动脉期为18±4.3(P<0.05),静脉期为20±6.1(P<0.05),延迟期CNR为21±4.8(P<0.05),3D CE MRACNR等于或高于T2WI,其肿瘤动脉显示率为80.4%,静脉显示率为26.8%,能显示肿瘤不同时相的强化特点。结论 3DCE MRA对腹部肿瘤检出率高,能显示肿瘤血管与组织强化特点,为诊断腹部肿瘤有价值的方法。

Objective To investigate the value of three-dimensional dynamic contrast-enhanced MR angiography (3D CE-MRA) in diagnosis of abdominal tumors. Methods Conventional MRI and 3D CE-MRA were performed in 26 patients with abdominal tumors. Detection rates of lesions and contrast-to-noise ratios (CNR) in 3D CE-MRA were compared with those in T2WI. Tumorous arteries and veins were counted and the enhanced patterns of lesions on multi-phases images were analyzed. Results There were total 41 lesions in all patients. In 37 tumors of parenchyma viscera, 29, 30 and 34 were detected by T2WI, ultrasound and arterial phase of 3D CE-MRA respectively, and 3D CE-MRA showed the highest detection rate of lesions. For liver tumors, CNR was 21±3.8, 13±4.6 ( P <0.05), 19±3.3 ( P >0.05) and 23±2.5 ( P <0.05) in T2WI, arterial, venous and delayed phases respectively. For other tumors, CNR were 15±5.8,18±4.3 ( P <0.05) and 21±4.8 ( P <0.05) in T2WI, arterial, venous and delayed phases respectively. The CNR of 3D CE-MRA was higher than or similar to that of T2WI. 80.4% of tumorous arteries and 26.8% of tumorous veins were demonstrated in 3D CE-MRA. The enhanced characterization of tumors was satisfactorily showed in 3D CE-MRA. Conclusion With high sensitivity to detect abdominal tumors and excellent ability to demonstrate tumorous vessels and enhanced patterns of tumor, 3D CE-MRA is a valuable method for diagnosing abdominal tumor.