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目的探讨MSCT、高场MR对肝转移瘤(Hepatic Metastases,HMs)介入治疗的指导意义。方法 21例HMs行介入治疗。介入治疗前先行MSCT、高场MRI动态增强扫描检查及血管重建。结果 MRI于平扫、动态增强扫描各期对病灶的检出率均高于MSCT,尤其增强扫描对直径<1 cm的病灶检出更显著高于MSCT(P<0.05)。血管重建显示情况:所有病例通过MSCTA均能显示3级以下肝动脉,与DSA完全相符;MRA成功显示16例,余5例由于患者呼吸配合欠佳而使血管显示不理想。所有病例通过MSCTA均能显示4级以下门静脉肝内分支;MRA成功显示13例,3例显影较淡而不能清晰显示4级以下门静脉肝内分支,余5例由于患者呼吸配合欠佳而使血管显示不理想。DSA肝动脉造影可间接显示门静脉,但3级以下肝内分支大都显示不清。结论 MSCT、高场MR的综合应用能提高HMs的检出率,通过快速的动态增强扫描能重建出高质量的肝动脉及门静脉血管像,且较DSA在诊断方面具有易操作性和非创性的优势,从而为合理制定HMs介入治疗方案提供重要的指导作用。
Objective To explore the guiding significance of interventional therapy of MSCT and high field MR on Hepatic Metastases (HMs). Methods 21 cases of HMs interventional treatment. Before interventional treatment MSCT, high field MRI dynamic contrast-enhanced scan and revascularization. Results The detection rate of lesions on MRI scan was higher than that of MSCT at all stages of contrast enhancement and dynamic contrast enhancement. In particular, the enhancement scan was more significantly higher than MSCT in lesions with diameter less than 1 cm (P <0.05). Vascular reconstitution showed that: All cases showed hepatic artery below grade 3 by MSCTA, which was completely consistent with DSA; MRA successfully showed 16 cases and the remaining 5 cases showed unsatisfactory vascularity due to poor respiratory coordination. In all cases, the intrahepatic branches of portal vein below grade 4 were shown by MSCTA. MRA successfully showed 13 cases, 3 cases developed lighter and could not clearly show the portal vein hepatic branches below grade 4, and the other 5 cases caused vascular respiration Display is not ideal. DSA hepatic artery angiography can indirectly show the portal vein, but most of the liver below grade 3 showed unclear. Conclusion The combination of MSCT and high-field MR can improve the detection rate of HMs. High-quality hepatic and portal vein images can be reconstructed by rapid dynamic contrast-enhanced scanning. Compared with DSA, it is easy to operate and noninvasive in diagnosis So as to provide an important guide for the rational development of HMs interventional therapy.