肝脏血管与胆道系统的MR图像三维重建与融合的初步研究

目的探索利用MR后处理工作站进行肝脏血管与胆管系统融合的方法及意义。方法12例手术病人术前同时行三维动态增强磁共振血管成像(three dimensional contrast enhanced magnetic resonance angiography,3D DCE MRA)及磁共振胰胆管成像(MR cholangiopancreatogra- phy,MRCP),包括6例肝硬化、4例肝癌、2例发生在胆总管的胆管细胞癌。两种序列采取一致的扫描范围、视野及层厚。利用MR后处理工作站分别进行血管与胆管系统的重建,然后将两者融合并形成三维动画。结果三种重建方法中.肝动脉、门静脉和肝静脉最大密度投影(maximum intensity projection,MIP)法重建观察的血管级数高于(surface shaded display,SSD)和容积重建(volume recon- struction,VR),胆管三种方法之间无统计学差别。重建和融合可同时显示肝内血管、胆管的解剖与异常及两者之间的关系。结论利用MR后处理工作站可在活体达到肝脏血管系统与胆管系统的融合,其解剖关系的显示有助于临床治疗方式的选择。

A preliminary study on 3D reconstruction and image fusion between CE-MRA and MRCP of hepatic blood vessels and biliary system

Objective To explore the method of fusion between the hepatic blood vessels and biliary duct at MR workstation and explore its clinical value.Methods A total of 12 patients received three dimensional contrast enhanced magnetic resonance angiography(3D DCE MRA)and MR cholan- giopancreatography(MRCP)at the same time before the surgery.The diseases included hepatic cir- rhosis in 6 patients,hepatocellular carcinoma in 4,cholangiocarcinoma in 2.In workstation,3D DCE MRA and MRCP were reconstructed with MIP,SSD and VR.Then they were fused together.Results In the reconstruction of hepatic blood vessels,the maximum intensity projection(MIP)was better than surface shaded display(SSD)and volume reconstruction(VR).But in reconstruction of the biliary sys- tem,there were no statistically significant differences among three methods.The reconstruction and fusion could simultaneously display anatomy and abnormalities of intrahepatie blood vessels and bile duct as well as relationship between the two.Conclusions Using the MR workstation,we can accom- plish the image fusion between the blood vessels and biliary tract.It is a good method for the anatomic information and therapeutic management.