MSCT血管造影评估原发性肝癌患者肝内外动静脉的应用价值  

Application value of MSCT angiography in the evaluation of intrahepatic and extrahepatic veins and arteries in the patients with primary liver cancer

作　　者：褚云 郑银元[1] 金赞辉[1] 

机构地区：[1]浙江省湖州市第一人民医院放射科,浙江湖州313000

出　　处：《中国现代医生》2018年第2期103-106,F0003,共5页China Modern Doctor

基　　金：浙江省科技计划项目(2013C33109)

摘　　要：目的探讨应用多层螺旋CT(multi-slice spiral CT,MSCT)血管造影评估原发性肝癌患者肝内外动静脉的价值。方法选取2010年5月~2016年8月间84例经病理或临床证实的原发性肝癌的患者进行回顾性分析,其中行三维增强磁共振血管成像(magnetic resonance angiography,MRA)检查的患者53例,MSCT血管造影检查患者71例,71例患者后期均采取最大密度投影(maximum intensity projection,MIP)及容积再现技术(volume representation technology,VRT),全部患者均行数字减影血管造影(digital subtraction angiography,DSA)检查。比较三种方法对原发性肝癌肝内外动脉、门静脉显示达到A级的差异,比较三种方法门静脉癌栓、动静脉瘘及供血动脉显示例数情况。结果腹外动脉、门静脉主干、一级肝动脉及一级门静脉,三种检查方法均可清晰显示,差异无统计学意义(P>0.05),二、三级肝内动脉、门静脉达到A级,MRA、VRT低于MIP、DSA,差异有统计学意义(P<0.05),MIP与DSA比较无统计学差异(P>0.05);门静脉癌栓、动静脉瘘及供血动脉检出例数比较,MRA、VRT低于MIP、DSA,差异有统计学意义(P<0.05),MIP与DSA比较无统计学差异(P>0.05)。结论 MSCT血管造影诊断具有敏感性高的优势,是一项行之有效的诊断方法。Objective To investigate the value of multi-slice spiral CT （MSCT） angiography in the evaluation of intrahepatic and extrahepatic veins and arteries in the patients with primary liver cancer. Methods A total of 84 patients with primary liver cancer confirmed pathologically or clinically from May 2010 to August 2016 were selected and retrospectively analyzed. Among them, 53 patients were given three-dimensional enhanced magnetic resonance angiography （MRA）, 71 patients were given MSCT angiography and 71 patients were given maximum intensity projection （MIP） and volume representation technology（VRT）. All patients were given digital subtraction angiography（DSA） examination. The difference of level A manifestations of intrahepatic and extrahepatic veins and arteries and portal veins was compared between the three methods, and the number of cases of portal vein tumor thrombus, arteriovenous fistula and blood supply were compared between the three methods. Results External abdominal artery, portal vein trunk, primary hepatic artery and primary portal vein could all be clearly shown by the three kinds of examination methods, and the difference was not statistically significant（P〉0.05）. The secondary and tertiary intrahepatic artery and primary portal vein reached to level A, and MRA and VRT were lower than MIP and DSA, the differences were statistically significant（P〈0.05）, and the difference between MIP and DSA was not statistically significant（P〉0.05）; the number of cases detected with portal vein tumor thrombus, arteriovenous fistula and feeding artery was compared, and MRA and VRT were lower than MIP and DSA, the differences were statistically significant（P〈0.05）. There was no significant difference between MIP and DSA （P〉0.05）. Conclusion MSCT angiography diagnosis has the advantage of high sensitivity, and it is an effective diagnostic method.

关 键 词：三维增强磁共振血管成像 多排螺旋CT血管造影 数字减影血管造影 

分 类 号：R445.2[医药卫生—影像医学与核医学]