多层螺旋CT图像后处理技术在原发性肝癌合并门静脉癌栓中的诊断价值

Diagnostic value of liver carcinoma with portal vein cancer thrombosis by multi-slice spiral CT of image post-processing technique

目的探讨MSCT肝脏多期增强扫描及图像后处理技术对原发性肝癌合并门静脉癌栓的诊断价值。方法回顾性分析43例经临床及CT诊断为原发性肝癌合并门静脉癌栓患者的MSCT多期增强扫描与图像后处理技术的影像学表现。图像重建方法有3种:多平面重建(MPR)、最大密度投影(MIP)和容积再现(VR)。结果动脉期MIP和VR结合清晰显示41例腹腔内血管及肿瘤供血血管。冠状位MPR重建显示37例癌栓大小、范围及管腔变窄程度。斜位MPR重建显示癌栓的范围及形态,10例呈局部结节状,20例呈团片状,7例呈不规则形。横断面MIP及动脉期VR显示28例门脉癌栓由肝动脉供血。MIP及MPR结合,6例显示邻近肿瘤对门脉的侵犯,40例显示门脉的侧支血管。结论MSCT肝脏增强扫描及图像后处理技术技术是诊断与评价原发性肝癌合并门静脉癌栓的有效手段,具有相当的优越性。

Aim To evaluate the value of enhancement scanning and image post-processing technique in diagnosis of liver carcinoma with portal vein thrombosis using multi-slice CT after multi-phase enhancement. Methods Forty-three cases of liver carcinoma with thrombosis underwent portal vein image post-processing with multi-slice spiral CT, including multi-planar re-construction （MPR） , maximum intensity of projection （MIP） and volume rendering（ VR ）. Results The methods of MIP and VR showed abdominal blood vessel and vessel-supply of liver carcinoma clearly in 41 patients in arterial phase. MPR of coronal directly showed the whole size, the extent of carcinoma thrombosis and lumen narrowing caused by carcinoma thrombosis in 37 patients. MPR of oblique position displayed roughly shape and extent of the carcinoma thrombosis. Carcinoma thrombosis was partly nodular in ten patients, lamellar in twenty patients and anornalism shape in seven patients. MIP of cross-section and VR of arterial phase showed that the blood-supply of carcinoma thrombosis is hepatic artery in 28 patients. The integration of MIP,VR clearly showed main portal vein encroachment by adjacent tumor in six patients, and branching portal vessels in forty patients. Conclusion The portal vein image post-processing technique of enhancement scanning is an effective diagnostic method for liver carcinoma with portal vein thrombosis.