三维动态增强磁共振血流成像对指导肺癌手术的价值

The value of 3D dynamic contrast enhanced MR angiography in predicting operability of lung cancer

目的 :研究三维动态增强磁共振血流成像 ( 3DDCEMRA)对肺癌侵犯血管的显示能力 ,探讨MRA术前对手术计划的指导价值。方法 :肺癌患者 2 6例 ,除常规MR检查外 ,注射Gd DTPA 0 .2mmol/kg后 ,冠状面动态三维超快速梯度回波采集 ,最大强度投影法 (MIP)重建。分析肺癌与血管的关系 ,与手术病理对照。结果 :2 6例中 2 5例肺部不同时相的血管显示清晰 ,9例肿瘤贴邻血管 ,另 16例可见肿瘤粘连或包绕大血管。结论 :3DDCEMRA可清晰显示肺段以上的肺动脉和肺静脉 。

Objective:To study the ability of 3D DCE MRA in demonstration of the invasion of the vessel by pulmonary cancer,and its value in predicting operability of pulmonary cancer.Methods:26 patients with pulmonary cancer underwent 3D DCE MRA besides conventional MRI sequences.The protocol of 3D DCE MRA was as follows: after intravenous bolus injection of 0.2ml/kg Gd DTPA,coronal 3D TFE keyhole images were obtained with 4 slices.The vessel images were reconstructed with MIP.The relationship of pulmonary cancer and the associated vessels was analyzed by correlating to surgical and pathological findings.Results:The pulmonary vessels in different phases could be demonstrated clearly with 3D DCE MRA in 25 of 26 cases.The masses adhered to the vessels in 9 cases,and surrounded or encased the vessels in the other 16 cases.Conclusion:The pulmonary vessels up to the segmental arteries and veins could be depicted clearly on the images of the 3D DCE MRA.It is useful for predicting operability of the pulmonary cancers.