磁共振肝脏容积加速采集增强血管成像在巨大肝脏肿瘤切除术中应用分析  

Application of LAVA CE-MRA in hepatectomy for huge hepatic tumor

作　　者：吴建伟[1] 瞿献莉[1] 高红[1] 吕毛古[1] 陆雷[2] 王轩[2] 

机构地区：[1]中国人民解放军第81医院影像科,江苏南京210002 [2]中国人民解放军第81医院肿瘤外科,江苏南京210002

出　　处：《中国实用外科杂志》2013年第11期960-963,共4页Chinese Journal of Practical Surgery

摘　　要：目的探讨磁共振肝脏容积加速采集（LAVA）增强血管成像在肝脏巨大肿瘤切除术中的应用价值。方法对2011年1月至2012年10月中国人民解放军第81医院收治的31例行肝脏肿瘤切除术术前行磁共振LAVA动态增强的临床资料进行分析，行多平面（MPR）血管重建，测量预保留肝脏的体积，评估肝脏肿瘤切除的可行性，并分析手术前后肝功能变化。结果磁共振血管造影（MRA）显示所有病人肝动脉、门静脉和肝静脉及主要分支以及与肿瘤的关系，10例行半肝切除术，7例行肝叶切除术，9例行肝段切除术，5例楔形切除术。10例半肝切除病人预保留肝体积为38％～84％。31例术后均存活，93．5％（29／31）术后1周恢复肝功能。结论LAvA增强检查能够准确显示肿瘤和血管关系，结合测量预留肝脏体积，对术前方案的制定具有重要作用。Objective To discuss the application of liver acquisition volume acceleration （LAVA）contrast-enhanced magnetic resonance angiography （CE-MRA） in hepatectomy for huge hepatic tumor. Methods From January 2011 to October 2012, the hepatectomy was performed in 31 patients with hepatic tumors in 81st Hospital of PLA. The LAVA CE-MRA was performed before operation. The reconstruction of hepatic vaseulature with multiplanar reconstruction （MPR） and measurement of remnant liver volume were performed to assess the feasibility of surgery. The results of liver function test before and after operation were also analyzed. Results CE-MRA showed the hepatic artery, portal veins, hepatic veins and their main branches as well as their relationship with the tumors clearly in all patients. The right and left hepatectomy were performed in 10 patients, lobectomy in 7, segmentectomy in 9 and wedge resection in 5. The remnant liver volume was 38% - 84% in 10 patients with hemibepatectomy. All patients were survival after operation. The recovery of liver function occurred 7 days postoperatively in 93.5% of patients. Conclusion Combining with volumetry of remnant liver, LAVA CE-MRA which showed the vasculature of liver and their relationship with tumors clearly can play an important role in preoperative planning of liver resection.

关 键 词：肝脏肿瘤 肝切除术 肝脏容积加速采集 磁共振血管成像 

分 类 号：R6[医药卫生—外科学]