各向同性快速三维容积动态增强序列在肝外胆管癌中的诊断价值  

Dignostic value of 3D-LAVA dynamic contrast enhancement series with isotropy scanning of MRI in extrahepatic cholangiocarcinoma

作　　者：秦昕东[1] 韩景娟[1] 苑晶[1] 冯荣平[1] 马莎莎[1] 刘海燕[1] 

机构地区：[1]山东省德州市人民医院放射科,山东德州253014

出　　处：《中国中西医结合影像学杂志》2012年第3期216-219,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:研究MRI各向同性并零填充插值优化技术下快速三维容积(3D-LAVA)动态增强序列对肝外胆管癌(EH-CC)的诊断价值。方法:回顾性分析经手术病理证实的28例EHCC的MRI平扫、磁共振胰胆管成像(MRCP)、各向同性并零填充插值优化3D-LAVA扫描原始图像及对基于后者进行的多方位重组图像和立体重建的图像资料,明确病变部位、大小、分型、邻近受侵及转移情况。结果:28例在MRI平扫及MRCP时均可显示梗阻段以上的胆系扩张,12例未见到明确的软组织肿块和浸润的胆管;而通过各向同性3D-LAVA图像后处理,28例均显示出明确的扩张胆管及渐进强化的软组织肿块,同时可以显示出癌灶与邻近血管和脏器的毗邻关系及受累情况。28例中近段肝外胆管癌18例,远段肝外胆管癌10例;浸润型15例,结节型8例,乳突型5例;血管受累7例,十二指肠乳头壶腹受累2例,腹腔淋巴结转移3例。结论:各向同性并零填充插值优化3D-LAVA不但可以显示EHCC的直接及间接征象,作出诊断并分型,还可以更直观清晰地显示病灶与重要脏器的毗邻关系,为临床提供更多的病变信息。Objective： To study the diagnostic value of the series of 3-dimensional LAVA （liver acquisition with volume acceleration） dynamic contrast enhancement with both isotropy scanning and zero filling interpolation processing of MRI in extrahepatic cholangiocarcinoma. Methods： The data of 28 cases with extrahepatic cholangiocarcinoma proved surgically and pathologically were retrospectively analysed,and the data were obtained from scanning by plain MRI, MRCP and the series of 3D-LAVA dynamic contrast enhancement with both isotropy scanning and zero filling interpolation processing of MRI,and from reformatting pictures in multiple directions and rebuilding pictures 3-dimensionally basing on the latter,so that their location,volume, type, adjacent infiltrated organ or vascular close to the lesion,focal metastasis and so on could be observed. Results.. By plain MRI and MRCP all of the dilatating bile ducts could be shown clearly of the 28 cases with extrahepatic cholangioearcinoma, soft tissue mass and thickened bile duct were able to be roughly showed except 12cases. While by the pictures reformatted from the series of 3D-LAVA dynamic contrast enhancement with both isotropy scanning and zero filling interpolation processing, all of the dilataring bile ducts and the mass enhanced increasingly were able to be observed in the same 28 cases,and the adjacent organ or vascular close to the lesions could be shown more clearly simultaneously. And the types were able to be defined in this way,that proximal and distal extrahepatic cholangioearcinoma occurred in 18 and 10 cases respectively. And the infiltrating type occurred in 15 cases,nodal-like type in 8 cases,and papillary-like type in 5 cases. And adjacent vessels were infiltrated in 7 cases,duodenal papilla was infiltrated in 2 cases,lymph node metastasis was found in 3 cases. Conclusion： 3D-LAVA dynamic contrast enhancement series with both isotropy scanning and zero filling interpolation processing not only can show the direct and indirect signs of extrahepatic

关 键 词：胆管肿瘤 磁共振成像 造影剂 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.8[医药卫生—诊断学]