磁共振门静脉成像对肝癌门静脉癌栓的影像学分型及优势

MRP in typing and superiority to the hepatocellular carcinoma with portal vein tumor thrombosis

目的探讨磁共振门静脉成像(MR portography,MRP)对肝癌门静脉癌栓的分型、影像学表现及优势。方法收集2006年3月至2009年12月经磁共振门静脉成像检查的126例原发性肝癌患者的资料,其中84例合并门静脉癌栓,对门静脉癌栓进行分型,分析各型癌栓的MRP表现。结果 (1)MRP对门静脉及肝内5级以上分支显示清晰;(2)84例肝癌门静脉癌栓中,Ⅰ型13例,Ⅱa型21例,Ⅱb型19例,Ⅲ型22例,Ⅳ型9例。门静脉癌栓表现为门静脉主干、分支或受累下腔静脉、肠系膜静脉内稍长T1异常信号,沿静脉走形,正常血流信号中断。结论磁共振门静脉成像是一种简便、易行的无创性血管成像技术,对门静脉及肝内分支显示清晰。对肝癌门静脉癌栓的检出率高,分型准确,为临床治疗方法的选择及预后判断提供了可靠依据。

Objecttive To explore the aplication of MRP in typing and superriority to the hepatocellular carcinoma with portal vein tumor thrombosis.Mothods 126 patients data with primary hepatocellular carcinoma were collected from March,2006 to December,2009 after the MRP imaging formation inspection,of those 84 examples with concurrent portal vein cancer embolism.Typing determination were made for portal vein tumor thrombosis,each tumor thrombosis’s MRP performance was analyzed.Results（1） MRP could clearly demonstrate the liver 5 grade or above branch demonstrations.（2） in 84 examples with liver cancer portal vein tumor thrombosis,13 examples belnged to type i,21 examples belonged to type Ⅱ a,19 examples type Ⅱb,22 examples typeⅢ,9 examples typeⅣ.The portal vein tumor thrombosis incolovedin the portal vein branch,the branch or exhausts oneself in the vena cava inferior,the mesentery vein the slightly long T1 signal,loses shape along the vein,normal blood stream signal interrupt.Conclusion MRP is a simple and fesible technique to determine,the protal vein and branches demonstration,portal vein tumor thrombosis.The detection rate is high in examing,typing is accurate,which provide the reliable basis for selecting clinical therapy and the prognosis judgment.