原发性巨块型肝细胞癌的MRI与血管造影的相关性研究

Comparative study of MR imaging and hepatic angiography in massive hepatocellular carcinomas

目的 对原发性巨块型肝细胞癌 (MHCC)的MRI和肝血管造影所见征象进行对照研究 ,探讨MHCC的MRI与肝血管造影表现的相关性。方法 5 0例原发性巨块型肝细胞癌病人 ,经MRI检查后 1周内行肝血管造影检查 ,MRI采用SE序列 ,矩阵 12 8× 2 5 6 ,层厚 5～ 10mm ,层间隔 1mm。肝血管造影采用Seldinger经皮穿刺股动脉插管技术 ,行肝动脉和间接门静脉造影。结果 (1)MRI和肝血管造影在显示门静脉内瘤栓或肝静脉内瘤栓方面无显著性差异 (P >0 .0 5 ) ;(2 )肝血管造影显示肝动脉与静脉分流的病例 ,在MRI上表现为病灶边缘部分或全部模糊不清 ;病灶一侧轮廓不规则 ;肝段或肝叶信号强度改变 ,病灶边缘流空血管增粗、增多。 (3)SET2 WI呈现高信号者与肝血管造影的肿瘤染色区相符合。

Objective Comparative study of magnetic resonance imaging (MRI) and hepatic angiography (HAG) in massive hepatocellular carcinomas (MHCC) To analyse the correlation of MRI with HAG in MHCC Methods 50 cases of MHCC underwent HAG followed by MRI in a week MRI: spin echo sequence was used with 128×256 matrix The section thickness was 5-10 mm with 1 mm gap HAG: Using Seldinger technique Hepatic arteriography and indirect portography were performed Results (1) There was no difference for HAG and MRI in displaying portal vein thrombosis and hepatic vein thrombosis (2) Cases with arteriovenous shunt demonstrated on HAG showed blurred and irregular margin of tumor and signal alteration of a segment or lobe (3)Area with high signal intensity on T 2 weighted spin echo image corresponded to the area of tumor staining on HAG Conclusion The MRI finding are correlated with those of HAG in HCC