三维动态增强磁共振血管成像对肝癌侵犯血管诊断的临床价值

Clinical value 3D CE MRA in the diagnosis of blood vessels involvement by liver cancer

目的探讨三维动态增强磁共振血管成像(3D CE MRA)对肝细胞癌侵犯血管的诊断的临床价值。方法回顾性分析了2008年4月～2009年2月我院治疗的60例肝癌患者。在介入治疗或肝脏手术前接受门脉3D CE MRA,采用仪器为Philips achiva 1.5testa超导型磁共振成像系统,扫描所获的原始图像经计算机重建成类似血管造影的3D CE MRA图,用于诊断门静脉、肝静脉、下腔静脉受侵情况。3D CE MRA的诊断结果同术中超声X线造影和手术-病理所见相对照。结果所有患者均顺利完成3D CEMRA。所有病例门静脉、肝静脉、下腔静脉均显示良好。手术或门脉造影发现受累血管门静脉23例,肝静脉15例,下腔静脉12例。3D CE MRA检测门静脉、肝静脉、下腔静脉的总体敏感性为97.2%,特异性为100.0%,阳性预测值为92.8%、阴性预测值为100.0%。结论3D CE MRA对肝癌侵犯血管的诊断具有较高准确性,且直观和无创伤性。

Objective To investigate the clinical value 3D CE MRA in the diagnosis of blood vessels involvement by liver cancer.Methods 60 patients with liver cancer from April 2008 to February 2009 in our hospital were retrospective analyzed.In interventional therapy or befor liver surgery accept portal 3D CE MRA,using instruments for Philips achiva 1.5 testa superconducting magnetic resonance imaging system type.Scanning of the original image obtained by computer heavy built similar angiographic 3D CE MRA figure,for the diagnosis of hepatic vein,the portal and inferior vena cava.3D CE MRA diagnosis with intraoperative X-ray imaging and surgery-pathological were contrasted.Results All of the patients were completed 3D CE MRA.All cases portal vein,hepatic vein,the inferior vena cava all had show good.Surgery or portal imaging found 23 casesof portal vein blood vessels,15 cases of hepatic vein,12 cases of inferior vena cava.3D CE MRA detection portal vein,hepatic vein,the inferior vena cava＇s overall sensitivity was 97.2% and specificity was 100.0%,the positie predictie alue was 92.8%,negatie predictie alue was 100.0%.Conclusion 3D CE MRA is accurate,simple and non-invasivewith in the diagnosis of blood vessels involvement by liver cancer