高场MR在肝转移瘤介入治疗中的应用价值

The Applied Value on High-field MR in the Interventional Treatment of Hepatic Metastases

目的探讨高场MR对HMs介入治疗的指导意义。方法21例HMs行介入治疗。介入治疗前先行高场MRI动态增强扫描检查及血管重建。结果共检出病灶111个:平扫发现病灶80个,动态增强扫描于动脉期发现病灶104个,门脉期发现病灶107个,延迟60min之后新发现4个直径<1cm的病灶。对直径<1cm的病灶检出,动态增强扫描明显优于平扫(P<0.05)。血管重建显示情况:MRA成功显示16例3级以下肝动脉,图像可与DSA相媲美,余2例由于患者呼吸配合欠佳而使血管显示不理想;成功显示16例4级以下门静脉肝内分支,3例显影较淡而不能清晰,余2例由于患者呼吸配合欠佳而使血管显示不理想。DSA肝动脉造影可间接显示门静脉,但3级以下肝内分支大都显示不清。结论高场MR能提高HMs的检出率,通过快速的动态增强扫描能重建出高质量的肝动脉及门静脉血管像,且较DSA在诊断方面具有易操作性和非创性的优势,从而为合理制定HMs介入治疗方案提供重要的指导作用。

Objective To discuss the applied value of High-field MR in the interventional treatment of hepatic metastases（HMs）. Methods 21 cases HMs were treated by interventional treatment before it High-field MR dynamic contrast-enhanced scanning and reconstruct angiography were performed first.Results Total of 111 lesions were detected： plain scan found 80 lesions, dynamic arterial phase scans in the 104 lesions, lesions found in the portal venous phase 107, after 60min delay in the newly discovered 4 diameter 〈1cm lesion. Of diameter 〈1cm lesion detection, dynamic contrast-enhanced CT scanning was superior （P〈0.05）. That the situation revascularization： MRA showed 16 cases of the success of the following three hepatic artery, and DSA images can be comparable to, more than two cases with the poor as a result of breathing in patients with vascular showed unsatisfactory;the success of 16 cases showed the following four iutrahepatic portal vein branch, three cases of light and not developing a clear, more than two cases with the poor as a result of breathing in patients with vascular display is not ideal. DSA hepatic arteriography showed that the portal vein may be indirect, but the intrahepatic branches of the following three shows are unclear.Conclusion High-field MR could improve the detection rate of HMs, high-qulity imagy of hepatic artery and portal vein could be reconsructed by fast dynamic contrast-enhanced scanning, and compared with DSA, it had the advantage of operat more easily and non-invasive, so as be a guide in the interventional treatment of HMs.