肝门区肿瘤的 MRI 诊断及临床应用  

Application value of MRI in diagnosis of hepatic hilar tumors

作　　者：孙丽娟[1] 孙丽艳[2] 赵春雷[1] 

机构地区：[1]通辽市医院影像科,内蒙古通辽028000 [2]通辽市医院妇产科,内蒙古通辽028000

出　　处：《实用放射学杂志》2015年第2期230-233,共4页Journal of Practical Radiology

摘　　要：目的：探讨 MRI（包括平扫、MRCP,动态增强、三维动态增强磁共振血管成像3D DCE-MRA ）对肝门肿瘤的定性诊断及术前评估的价值。方法分析56例肝门区肿瘤的 MRI 表现,其中肝细胞癌12例,胆管癌24例,其他肿瘤（神经鞘瘤、血管瘤、局灶性结节性增生、血管平滑肌脂肪瘤、静脉瘤、转移瘤、类癌、纤维肉瘤、淋巴瘤、囊腺癌、癌肉瘤等）20例,并与手术或病理结果比较。结果平扫＋MRCP 对胆管梗阻水平定位准确率达91.1%（51/56）,MRI 对肿瘤能否切除的评估准确率为78.6%（33/42）。运用4种组合方法进行评估：（1）平扫＋MRCP；（2）平扫＋动态增强；（3）,（2）＋MRCP；（4）,（3）＋3D DCE-MRA。（1）和（2）的定性诊断准确率差异有统计学意义,（2）、（3）、（4）定性诊断准确率差异无统计学意义,（1）、（3）、（4）的术前评估准确率差异有统计学意义。各种类型肿瘤门静脉3D DCE-MRA 表现形式不同,差异有统计学意义。结论联合 MRI 方法对肝门肿瘤诊断及术前评估具有重要意义。Objective To investigate the value of the MRI （including plain scanning,dynamic contrast-enhanced MR,MRCP and 3D DCE-MRA）in the diagnosis and preoperative assessment of hepatic hilar tumors.Methods The MR appearances of some hepatic hilar tumors in 56 patients were analyzed including hepatocellular carcinoma in 12,cholangiocarcinoma in 24 and other tumors in 20 （neurinoma,hemangioma,focal nodular hyperplasia,angiomyolipoma,veinous angioma,metastases,carcinoid,fibrosarcoma,lympho-ma,carcinosarcoma and cystadenocarcinoma）.The MR appearances were compared with the results of surgery or pathology.Four combined methods were used for the accuracy evaluation including：（1）plain scanning ＋ MRCP,（2）plain scanning ＋ dynamic en-hanced MRI,（3）（2）＋MRCP,（4）（3）＋DCE-MRA.Results MRCP showed an accuracy rate of 91.1% to determine the bile duct obstruction,and overall MRI showed an accuracy rate of 78.6% in preoperative evaluation.The difference in the accuracy of qualita-tive diagnosis between （1）and （2）and that in the accuracy of preoperative evaluation between （1）,（3）and （4）were statistically signif-icant.However,no difference in the accuracy of qualitative diagnosis was found between （2）,（3）and （4）.The appearances of 3D DCE-MRA of portal vein in all kinds of tumors were different with significant differences.Conclusion Combined application of dif-ferent MRI methods is helpful for the diagnosis and preoperative evaluation of hepatic hilar lesions.

关 键 词：肝门肿瘤 磁共振成像 定性诊断 术前评估 

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