三维动态增强磁共振血管造影诊断门静脉癌栓等肝癌血管并发症的价值

目的 评价三维动态增强磁共振血管造影（3D-DCE-MRA0在术前诊断肝癌并发门静脉癌栓及其他血管性并发症的价值。方法 回顾分析3D-DCE-MRA诊断为门静脉癌栓形成的37例MRA表现，并与常规MRI，手术或门静脉造影对比。评价门静脉主干，右支，左支是否有门静脉癌栓形成，及是否并发肝动静脉瘘，门静脉海绵样变等肝内血管改变。结果 手术或门静脉造影证实其中33例门静脉癌栓诊断正确，3D-DCE-MRA对门静脉癌栓的诊断特异性为89.2%。敏感性为94.3%，并提示9例门静脉海绵样变，7例肝动静脉瘘形成，而常规MRI对门静脉癌栓显示的敏感性，特异性为60.6%,80.0%,3D-DCE-MRA在显示门脉癌栓，门静脉海绵样变，肝动静脉瘘等方面明显优于常规MRI。结论 3D-DCE-MRA能较清楚地显示门脉癌栓。门静脉海绵样变，肝动静脉瘘等肝癌血管性并发症。可用于评价肝癌的分期及治疗方案的选择。

Value of 3D dynamic contrast-enhanced magnetic resonance angiography in diagnosing portal cancerous thrombosis and hepatic vessel involvement of hepatocellular carcinoma

Objective To assess the value of 3D dynamic contrast-enhanced magnetic resonance angiography (3D DCE MRA) in diagnosing portal cancerous thrombosis and hepatic vessel involvement of hepatocellular carcinoma (HCC). Methods The data of 37 cases of 3D DCE MRA proved portal cancerous thrombosis were retrospectively. Meanwhile, the results were compared with those of surgery, portography and routine MRI. Results The sensitivity and specificity in detecting portal cancerous thrombosis were higher by 3D DCE MRA than by routine MRI (94.3% versus 60.6% and 89.2% versus 80.0%, respectively). Furthermore, 9 portal cavernous formation and 7 hepatic artery portal shunts were detected by 3D DCE MRA. 3D DCE MRA was superior to routine MRI in imaging portal cancerous thrombosis, portal cavernous formation and artery portal shunts. Conclusions 3D DCE MRA is quite accurate in evaluating portal cancerous thrombosis, portal cavernous formation, artery portal shunt and other vascular involving complicated hepatic carcinoma. It can be used in evaluating tumor status and selecting therapeutic procedures.