MRI常规序列结合3D-VIBE序列在肝门部胆管癌诊断中的应用  

Application of MRI routine sequence and 3D-VIBE sequence in the diagnosis of hepatic portal cholangiocarcinoma

作　　者：戴兴社[1] 杨晓彤[1] 郑琼[1] 张婧[1] 侯斌[1] 

机构地区：[1]兰州大学附属天浩医院影像诊断科,730060

出　　处：《中国临床研究》2010年第6期452-454,共3页Chinese Journal of Clinical Research

基　　金：甘肃省科技厅科研项目(2008Y0720)

摘　　要：目的探讨核磁共振成像(MRI)常规序列结合三维容积式内插法屏气检查(3D-VIBE)序列平扫及动态增强扫描在肝门部胆管癌诊断中的应用价值。方法收集12例经手术和病理证实的肝门胆管癌资料,分析MRI多种序列图像上肿瘤的征象以及3D-VIBE钆动态增强扫描征象。同时判断瘤体的存在、侵犯范围及对肝门结构的侵犯程度。结果 12例肝门胆管癌中,MRI常规序列,包括磁共振胰胆管成像(MRCP),显示9例瘤体,3例瘤体未显示;3D-VIBE序列显示11例瘤体,1例瘤体未显示。11例瘤体在3D-VIBE序列平扫图像上为等信号或低信号,动态增强表现为缓慢持续强化。3D-VIBE序列动态增强扫描显示了11例瘤体的侵犯范围及肿块对肝门血管的侵犯程度。结论 MRI常规序列结合3D-VIBE序列技术平扫及动态增强扫描具有很高的空间分辨率与时间分辨率,有助于肝门部胆管癌的诊断、分型,对临床制订手术方案具有重要的指导意义。Objective To study the value of the combination of MRI routine sequence and three-dimensional volumetric interpolated breath-hold examination（3D-VIBE）sequence in diagnosis of hepatic portal cholangiocarcinoma.Methods Datas of 12 patients with hepatic portal cholangiocarcinoma confirmed by surgery and pathology were gathered,and the images of MRI routine serial（including MRCP）and 3D-VIBE serial（including gadolinium dynamic-enhanced 3D-VIBE）were retrospectively analyzed for judging the exist of the tumor and assessing infiltration extent of the tumor and invaded degrees of hepatic portal structure.Results In 12 hepatic portal cholangiocarcinoma,9 tumors were showed on MRI routine sequence and 11 tumors were showed on 3D-VIBE sequence,and 1 tumor was not showed on both MRI routine sequence and 3D-VIBE sequence. Images of tumors were lower or equal intensity on 3D-VIBE scanning images（no contrast） and were enhanced gradually on gadolinium dynamic-enhanced 3D-VIBE triple-phase acquisitions.The infiltration extent of tumors and invaded degrees of vessels in hepatic portal were accurately showed on 3D-VIBE images.Conclusions The combination of MRI routine sequence and 3D-VIBE scanning and dynamic-enhanced sequences is beneficial for diagnosing and classifying hepatic portal cholangiocarcinoma due to its high spatial and temporal resolution.It will likely have significant role in making operative scheme of hepatic portal cholangiocarcinoma.

关 键 词：胆管肿瘤 肝门部 三维容积式内插法屏气检查 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤] R445.2[医药卫生—临床医学]