磁共振灌注成像在原发性肝癌中的临床应用

Clinical application of MR perfusion weighted imaging in primary hepatic carcinoma

目的：探讨磁共振灌注成像在原发性肝癌临床治疗中的应用价值。方法：32例拟行临床治疗的原发性肝癌患者,于临床治疗前2-3 d行MRI平扫、增强及灌注成像,然后将扫描结果进行统计学处理,计算灌注值、重建灌注图。结果：原发性肝癌为高动脉灌注、低门脉灌注;将原发性肝癌病灶中心与边缘相比,肝动脉灌注量（HAP）,门静脉灌注（PVP）、肝动脉灌注指数（HPI）差异有统计学意义（P〈0.05）,病灶中心的HAP、HPI高于边缘,PVP低于边缘;病灶中心与边缘的全肝灌注量（TCP）差异无统计学意义（P〉0.05）;边缘模糊瘤灶的PVP高于边缘清晰瘤灶,边缘模糊瘤灶有更多门脉参与供血。结论：磁共振灌注成像除能提供解剖图像外,还能反映组织血流灌注情况,可为治疗方案的选择提供依据。

Objective：To investigate the value of clinical application of MR perfusion imaging（PWI） in primary hepatic carcinoma（PHC）.Methods：32 cases of PHC underwent MRI plain and enhanced scanning,and PWI on 2~3 days before treatment.The perfusion parameters were calculated,perfusion imagings were reconstructed,and all data were statstiscally analyzed.Results：Primary hepatic carcinoma showed obviously high perfusion on hepatic artery phase（HAP） and low perfusion on portal vein phase（PVP）.Comparing of the PWI of the center and periphery of the PHC,significant statistical differences were existed on HAP、PVP and hepatic perfusion index（HPI）（P0.05）.The PWI on HAP and HPI of lesion center were higher than that of periphery and the PWI on PVP was lower in the lesion center compared with that of periphery.No statistical difference of total liver perfusion（TLP） was existed（P0.05）.The PWI on PVP of lesions with blurred margin were higher than that with clear margin,indicating more portal blood flow was existed in the former.Conclusion：Apart from anatomic imagings,MR PWI provided more knowledge of tissue blood perfusion and is helpful in treatment planning.