肝脏三维容积超快速多期动态增强术前评估原发性肝癌  

Liver acceleration volume acquisition dynamic enhanced MRI in preoperative evaluation of primary liver cancer

作　　者：林志超[1] 罗良平[1] 史长征[1] 龚瑾[2] 曹明溶[2] 王永安[1] 

机构地区：[1]暨南大学附属第一医院影像中心,广东广州510630 [2]暨南大学附属第一医院肝胆外科,广东广州510630

出　　处：《中国介入影像与治疗学》2012年第9期681-684,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：广东省自然科学基金(5006074);广东省医学科学技术研究基金(A2007339)

摘　　要：目的探讨肝脏三维容积超快速多期动态扫描(LAVA)在原发性肝癌术前评估中的价值。方法 收集经手术病理证实的60例原发性肝癌患者,随机分为LAVA组和二维快速扰相梯度回波T1(2D-FSPGR T1)组,各30例,LA-VA组接受平扫+LAVA动态增强;2D-FSPGR T1组接受平扫+2D-FSPGR T1动态增强。由2名放射科医师及2名肝胆外科专家对2组资料进行判读与分析,包括病变的定位、定性诊断、指导手术的价值及保留肝容积预测准确率。结果 LAVA组和2D-FSPGR T1组肿瘤定位诊断准确率分别为100%(63/63)、92.31%(48/52),差异有统计学意义(χ2=6.84,P=0.03);定性诊断准确率分别为96.83%(61/63)、82.69%(43/52),差异有统计学意义(χ2=6.06,P=0.01)。2名肝胆外科专家评估2D-FSPGR T1和LAVA指导手术价值的一致性满意(Kappa>0.75)。保留肝容积预测准确率LAVA组和2D-FSPGR T1组分别为99.64%(99.65/100.01)、0。结论 与2D-FSPGR T1技术相比,LAVA可清楚显示肝癌病灶的特征、部位及其与邻近血管的关系,在增强扫描方面可取代前者,对术前制定手术方案有重要指导意义。Objective To investigate the value of liver acceleration volume acquisition （LAVA） dynamic enhancement in preoperative evaluation of primary liver cancer. Methods Sixty patients of primary liver cancer confirmed with pathology were enrolled and were randomly divided into LAVA group and 2D-FSPGR T1 group. MR plain scan and LAVA dynamic enhancement were done in LAVA group, while plain scan and 2D-FSPGR dynamic enhancement were performed in 2D FSPGR T1 group. The value of localization, qualitation, guiding surgery and predicting of the resected and reserved vol ume of liver were analyzed by 2 radiologists and hepatobiliary surgery experts. Results The accuracy of tumor localization was 100% （63/63） in LAVA group, while was 92.31% （48/52） in 2D-FSPGR T1 group （X2=6.84, P=0. 03）. The qualitative diagnostic accuracy in LAVA group was 96.83 % （61/63）, while was 82.69 %（43/52） in 2D-FSPGR T1 group （X^2= 6.06, P=0.01）. The inter-observer accordance between 2 doctors were satisfactory （Kappa〉O. 75）. The accuracy rate of predicting the keep liver volume in LAVA group was 99.64% （99.65/100.01）, while in 2D-FSPGR T1 group was 0. Conclusion Compared with 2D-FSPGR T1, LAVA can clearly show the characteristics of liver cancer, as well as the relationship between tumor and adjacent vessels, therefore is able to replace enhanced 2D-FSPGR T1 scanning, and having important value in the preoperative evaluation.

关 键 词：肝脏肿瘤 磁共振成像 诊断显像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]