MR True FISP序列在评价肝癌侵犯门脉诊断中的应用研究

目的：探讨磁共振真实稳态进动快速成像（MR True FISP序列）用于诊断肝癌侵犯门脉的准确性，建立无创影像学检查技术对肝癌侵犯门脉的评价体系，指导手术治疗。材料及方法：收集临床已确诊为肝癌，并高度怀疑门脉受侵的患者90例，并有完整的MRI检查资料，所有患者均明确手术或穿刺病理证实。将所有MRI图像进行汇总分析，最后将True FISP序列检查结果与增强门脉期检查结果及手术或穿刺病理结果对比并进行对比分析。结果：建立MR True FISP序列的最佳成像参数和扫描方法。True FISP图像与增强门脉期冠状位图像大部分为优，二者的可诊断率均为100%。与病理对照分析，True FISP序列对肝癌侵犯门脉的显示有高度的一致性。结论：规范MR True FISP序列显示门脉的最佳成像参数和扫描方法；MR True FISP序列可以很好的显示肝癌病灶对门脉的侵犯情况，对诊断肝癌侵犯门脉的准确性很高，建立无创影像学检查技术对肝癌侵犯门脉的评价体系，从而指导外科手术治疗。

Application of MR True FISP sequence in evaluating invasion of portal vein by hepatic carcinoma

Objective： To explore the accuracy of magnetic resonance true fast imaging with steady precession （True FISP） in diagnosing invasion of portal vein by hepatic carcinoma and establish the valuable system of non-invasive imaging technology to assess portal vein invaded by hepatic carcinoma and the method of choice for surgical planning. Materials and Methods： Ninety cases with clinical diagnosis of liver carcinoma and highly suspicious of having portal vein invasion were collected, all cases were proved by surgical pathology or lesion biopsy. The features of MRI were collected and analysed, the features of True FISP were correlated with the images of portal venous phase enhancement, surgical results, and/or biopsy results. Results： Both of the image quality of True FISP sequence and portal venous phase enhancement images were good, and were 100% diagnostic. True FISP sequence in the diagnosis of portal venous invasion by hepatic carcinoma has good correlation with pathologic results. Conclusion： Standard MR True FISP sequence proved to be the best image modality for displaying portal vein and liver lesions. MR True FISP can be used to diagnose portal venous invasion due to hepatic carcinoma accurately, and can be used to establish a valuable system of non-invasive imaging examination for showing portal invasion by liver cancer, thereby useful in guiding surgical planning.