VIBE序列在原发性肝癌MRI诊断中的价值

目的评价MRVIBE序列多期增强扫描技术诊断原发性肝癌的价值。方法对32例经手术及病理证实的原发性肝癌患者分别采用常规MR(T1W1、T2WI)序列和VIBE序列扫描，先行各序列平扫，再进行VIBE多期增强扫描和2D-TlWI增强扫描；观察VIBE增强扫描各时相肿瘤的MR征象、VIBE资料重建后对病灶血管及肝血管解剖的显示，评价各序列对病灶的显示及定性能力。结果VIBE多期增强扫描发现42个病灶(100％)．明显多于2D-TlWI增强扫描发现的38个病灶(90．5％)．P＜O．05；T1WI平扫和T2WI分别发现病灶为30个(71．4％)和33个(78．6％)，P＜O．05。30例(93．8％)患者在VIBE序列多期增强扫描动脉期显示肝动脉系统图像质量达2级．3l例(96．9％)患者门脉期显示血管图像质量为2级；经MPR、MIP重建，14个病灶可清晰显示供血动脉．12个病灶显示引流静脉。结论MR 3D-VIBE序列多期增强扫描在病灶细节、供血动脉及肝血管解剖的显示上较常规序列具有更高的价值。

Value of MR Imaging with Contrast-Enhanced Multi-Phasic Isotropic Volumetric Interpolated Breath-Hold Examination in Diagnosing Primary Liver Carcinoma

Objective To evaluate the value of MR imaging with a contrast enhanced multi phasic isotropic volumetric interpolated breath hold examination (VIBE) in diagnosis of primary liver carcinoma. Methods Thirty two consecutive patients with surgical pathologically confirmed 42 foci of primary carcinoma of liver underwent comprehensive MR examination of the upper abdomen, routine two dimensional (2D) T1WI and T2WI images were acquired before administration of Gd DTPA for contrast enhancement. Then, contrast enhanced multi phasic VIBE was acquired followed by 2D T1WI images. The lesion appearances on hepatic arterial, portal venous and equilibrium phases of VIBE sequence were carefully observed along with delineation of hepatic arterial and portal venous structures. The lesion detection rates and lesion characterization ability were compared among various MR sequences. Results 33(78.6%), 30(71.4%), 38(90.5%) and 42(100%) foci were displayed respectively on T2WI, non enhanced T1WI, enhanced T1WI and enhanced 3D VIBE images ( P <0.05). The hepatic arterial anatomy of 30 patients (93.8%) and the portal venous structure of 31 patients (96.9%) were clearly depicted on enhanced 3D VIBE images. Using MIP and MPR reconstruction techniques, the feeding arteries of 14 foci and draining vein of 12 foci were clearly displayed.Conclusion High quality 3D VIBE images are not only better than 2D images in lesion detection and characterization for primary liver carcinoma, but also able to provide much more information about hepatic vascular anatomy.