摘要
目的:通过多层螺旋CT(MSCT)肝脏三期扫描,研究肝脏血管成像在肝脏肿瘤的诊断与治疗中的作用。材料和方法:75例怀疑或者已知肝脏肿瘤的患者行MSCT肝脏三期扫描,男性46例,女性29例,平均年龄56岁,年龄范围24～77岁。其中肝细胞癌45例,血管瘤15例,腺瘤3例,肝转移癌12例,病理确诊51例(68%),其余24例(32%)经临床随访与治疗和实验室检查确诊。通过病人肘静脉以3ml/s速度注射90～120ml含碘对比剂,在注射对比剂后25s、50s、90s开始扫描,获得相应动脉期、门静脉期、平衡期图像。所有数据采用1mm薄层重组,0.5mm薄层间距,然后传输到工作站进行VR、MIP图像重组。结果:通过多层螺旋CT三期扫描血管成像和图像后处理,MSCT图像可清晰显示肿块和部分肿块的供血动脉和引流静脉。在肝动脉期,42例肝细胞癌病例清楚显示肿瘤血管及其供血动脉,其中20例DSA对照检查,MSCT图像分析结果与DSA相一致;9例动静脉瘘形成;门静脉期,16例显示门静脉癌栓,门静脉闭塞5例。在肝动脉期,14例肝血管瘤清楚显示肝动脉及其分支供血,与DSA所见一致,门静脉期均见其引流静脉及其小分支。3例腺瘤在肝动脉期明显强化,均见其供血动脉。10例肝脏转移癌在肝动脉期见肿块边缘有细小供血动脉。结论:MSCT血管成像作为一种无创、简便的检查方法,利用VR和MIP相结合的成像方法可提供更详细的肝脏肿瘤的血管信息,尤其在显示肿瘤、供血动脉、引流静脉、肿瘤侵犯血管方面,为肝脏肿瘤的诊断与治疗提供了帮助。
Purpose： To evaluate the effect of hepatic angiography on diagnosis and therapy of liver tumor. Materials and Methods：75 patients（46 men,29 women; mean age, 56 years; range, 24 - 77years） with suspected or known hepatic tumors underwent triple - phase MSCT. Hepatocellular carcinoma（HCC） was diagnosed in 45 of the 75 patients, hepatic adenoma was in 3, cavernous hemangioma was in 15 and metastases was in 12. Pathologic proof was obtained in 51 patients（68% ） , the other cases were proved by clinical, therapic and laboratory findings. All patients were administered 90 - 120ml of Ⅳ contrast material at an injection rate of 3ml/s. The scan delay time was 25s, 50s, 90s for arterial, portal venous and hepatic venous phase, respectively. All data sets were reconstructed in 1 - mm section and 0.5ram interval, and then were set to a workstation for maximum intensity projection（MIP） and volume rendering （VR） reconstruction. Results： Using triple- phase hepatic angiography and advanced image processing, MSCT can clearly reveal hepatic tumors, feeding arteries or draining veins of some tumors. Tumor vessels and feeding arteries of HCC were shown in 42 case in hepatic arterial phase images, MSCTA had significant consistency with DSA in 20 of 42 cases. Arteriovenous fistula were detected in 9 case. In portal venous phase images, portal thrombosis were detected in 16 cases, venous occlusion in 5 cases. Feeding arteries of cavernous hemangioma were detected in 14 cases in arterial phase , which was completely consistent with DSA, draining veins and small branches were also found in portal venous phase. The enhancement pattern for hepatic adenoma in 3 cases were hypervascularity in arterial phase and feeding arteries were also found. Small feeding arteries of metastases were seen around lesions in 10 cases in arterial phase. Conclusion： As a non - invasive and convenient method, MSCTA provides more detailed vascu- lar information of hepatic tumors with MIP and VR image together, especially for detecting tumors, feeding arteries, draining veins and invaded vessels, which is good for diagnosis and therapy of liver tumor.
出处
《中国医学计算机成像杂志》
CSCD
2008年第2期139-143,共5页
Chinese Computed Medical Imaging
基金
四川省科技厅资助项目05JY029-012-1~~
关键词
多层螺旋CT
血管成像
肝脏肿瘤
Multi- slice spiral CT
Angiography
Hepatic tumors
