肝脏占位病变术前MRI定位探讨

Preoperative Segmental Localization of Hepatic Space Occupying Lesion:Utility of MR Imging

作者采用Ｂｉｓｍｕｔｈ肝脏八分段法对６８例肝占位病变的术前ＭＲ定位进行回顾性分析。ＭＲ对肝脏左中右静脉的显示率分别为９４．１％（６４／６８），９７．１％（６６／６８），１００．０％（６８／６８）。肝内门静脉左右支主干显示率分别为９５．６％（６５／６８）和１００．０％（６８／６８）。由于能够清楚地显示血管，ＭＲ可以对肝脏进行正确分段。与手术比较，ＭＲ定位的准确率为８９．７％（６１／６８）。ＭＲ对局限性病灶定位准确率相对较高，可达９１．３％（４２／４６）。当病灶较大，跨越多个肝段时ＭＲ定位准确率为８６．４％（１９／２２）。总之，ＭＲ是肝脏病变术前定位的一种有效手段，可以用来帮助外科医生制定治疗方案。

To evalute the accuracy of preoperative segmental localization. the MRI findings in 68 cases with hepatic space occupying lesions were retrospectively studied and compareted with the result of surgery.The hepatic and portal venous anatomy was used as the major landmarks for recog-nizing hepatic segmental anatomy.The right middle and left hepatic veins were seen in 100.0%,97.1%and 94.1%on MRI,the right and left portal veins were seen in 100.0%and g5.6%。The overall accuracy in determining the segmental location of hepatic lesion was 89.7%,and increased to 91.3%if the lesion was limited to a segment,while dropped to 86.4%when the lesion was more ex-tensive involving several segments.From this;tudy MRI has proved to be a helpful preoperative tool for segmental localization of hepatic masses.