三维MR动态增强扫描在壶腹癌诊断中的价值

目的研究三维磁共振动态增强扫描(3D CE M R I)及多层面重建(M PR)在壶腹癌诊断中的价值。方法对15例壶腹癌患者进行常规M R平扫和磁共振水成像(M RCP),三维容积超快速多期动态增强扫描(3D LAVA)序列进行动态增强扫描,对M RCP采用最大强度投影(M IP)和M PR,3D M R I采用M PR方式进行图像重建,主要观察肿瘤强化方式、胆总管及十二指肠腔内病变显示情况。结果3D M R I扫描表现:动脉期至平衡期呈轻度至中度逐渐明显异常强化7例;平衡期轻度强化2例;延迟8~10分钟后强化3例;无明显强化3例。M PR重建图像显示总管梗阻端腔内病变3例,十二指肠肠腔内病变4例。结论3D M R I扫描有利于壶腹癌病灶范围的观察及管腔内病变的显示,M PR重建图像对肿瘤向管腔内侵犯显示更直观。

Diagnostic value of 3-dimensional contrast enhanced magnetic resonance imaging in periampullary carcinoma

Objective To study the value of 3-dimensional contrast enhanced magnetic resonance imaging(3D CE MRI) and MPR in the diagnosis of peri-ampullaris carcinoma.Methods Fifteen cases of peri-ampullaris carcinoma underwent routine MRI scanning,MRCP and 3D LAVA.Maximum intensity projection(MIP) and multiplanar reconstruction(MPR) were used for images reconstruction in patients who underwent MRCP.Multiplanar reconstruction(MPR) was also applied for images reconstruction in patients who underwent 3D MRI.All the regimens mentioned above were mainly to identify how the peri-ampullaris carcinoma enhanced,and the signs of the lesions from choledochus and dodecadactylon lumen.Results On the 3D MRI images,peri-ampullaris carcinoma showed mild or moderate enhancement in seven cases from the artery phase to balanced phase.During the balanced phase,mild enhancement could be seen in 2 cases.Enhancement could be displayed in 3 cases during the lateral phase just after 8-10 minutes.While there was also slight enhancement in 3 cases.Images reconstruction with multiplanar reconstruction(MPR) showed the lesions from the obstructional port of common bile duct in 3 cases and from dodecadactylon in 4 cases.Conclusion 3D MRI is useful for displaying peri-ampullaris carcinoma and the lesions from the dodecadactylon lumen.Images reconstruction with multiplanar reconstruction(MPR) can show more clearly the invasion into the lumen by the carcinoma.