肝脏磁共振血管造影术:与DSA及CTAP的比较研究

目的通过与DSA及CTAP的比较研究,评价动态增强MRA在肝移植受体术前血管系统检查中的应用价值。方法16例肝疾病患者在2周内行肝脏MRI及动态增强(利用SENSE技术)MRA、DSA和CT经动脉门脉造影(CTAP)检查。MRA图像重建自冠状位3D动态增强扫描,动脉期MRA与DSA比较,门脉期MRV与CTAP比较。动态增强MRA采用20ml造影剂和统一扫描延迟时间。结果动态增强MRA能很好显示肝动脉系统各主要分支及变异;MRV对门脉系统的显示质量等于甚至超过CTAP;MRV能很好显示下腔静脉;MRV尚意外发现了1例DSA上未能显示的血管变异。结论动态增强MRA能清晰显示肝移植受体术前的血管结构,其有可能成为原位肝移植受体术前首选的影像学检查手段。

The Dynamic -enhanced MR Angiography of the Liver:A Comparision Study with DSA and CTAP

Objective To assess the role of dynamic-enhanced MR angiography (MRA) by comparing with DSA and CT arterial portography (CTAP).Methods Sixteen patients with liver diseases (mainly HCC) were included in the study. All patients underwent dynamic MRI of the liver using SENSE, digital subtraction angiography (DSA) and CTAP within two-week. MRA was reconstructed from raw data. The arterial phase of the modified MRA was compared with DSA for the evaluation of hepatic arteries and the portal phase compared with CTAP. In dynamic MRI, a fixed dosage (20 ml) of contrast medium and scan timing were used. Results The main branches and variations of the hepatic arterial system were well displayed on the dynamic-enhanced MRA, although the distant intrahepatic branches were showed poorly. Portal veins on MRV were showed as well as or even superiorly to CTAP. In addition, the inferior vena cava (IVC) was well demonstrated on MRV in most cases. MRV revealed 1 vascular variation which was not found on DSA and CTAP.Conclusion The dynamic-enhanced MRA using SENSE was a effective modality in demonstrating the hepatic vascular system. It may be a first choice modality in preoperative evaluation of orthotopic liver transplantation.