原发性肝癌门静脉癌栓MRI和DSA比较

目的：以血管造影表现作为诊断标准，用非侵入性磁共振成像（ＭＲＩ）检查评价门静脉癌栓。方法：磁共振为１．０Ｔ超导系统，轴位扫描序列为ＳＥ序列Ｔ１权重和Ｔ２权重及小角度扫描法（ＦＬＡＳＨ）序列，数字减影血管造影术（ＤＳＡ）为ＰｈｉｌｉｐｓＣ２０００数字减影血管造影机，造影中采用减影技术。结果：２０例原发性肝癌伴有门静脉癌栓形成的ＤＳＡ表现，１３例门静脉癌栓腔内缺损ＭＲＩ表现为异常信号取代正常的门静脉流空；４例门静脉闭塞表现为门静脉截断；３例门静脉弥漫性狭窄表现为门静脉不规则狭窄。结论：ＭＲＩ敏感性高，特征性强，而且无创伤性

Comparision of MR with DSA in portal vein thrombosis associated with hepatocellular carcinoma

Objectives:To assese portal vein thrombosis in patients with primary heptocellular carcinoma with MR imaging.The findings on MR were compared with angiographic findings which were used as the gold standard for diagnosis. Methods: We compared the findings of portal vein thrombus on MR and selective celiac and hepatic or superior mesenteric angiograthy in 20 patients with hepatocellular carcinoma.MR imaging was porformed with 1.0T superconducting magnet system.Both T1 and T2 weighted images of SE and FLASH sequence were obtained in transverse plane.Selective angiography was performed at Philips 1250mA digital substractive X ray.Substractive technique was used in the course of angiography.Results:Portal vein thrombosis on DSA in patients with hepatocellular carcinoma were demonstrated as filling defect,portal occlusion,thread and streams sign,arterioportal shunt,nonopacification of the portal vein and cavernous transformation.Intrinsic clot was in 10 patients.Four cases showed portal occlusion.Three cases had diffused narrow portal vein. Conclusions:MR of portal vein thrombus in primary hepatocellular carcinoma had intrinsic defect,portal stump,diffusely narrow and collateralization.MR had more sensetive and specific and was noninvasive mortality.