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

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1、MSCT血古験脚橋患者肝邮卜義棚应用備2018-03-2110:12:00中国现代医生2018年2期褚云郑银元金赞辉［摘要］目的探讨应用多层螺旋CT(multi-slicespiralCT,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冋顾性分析，其屮行-:维增强磁共振血管成像(magneticresonanceangiography,MRA)检S的患者53例，MSCT血管造影检查患者71例，71例患者后期均采取鉍大密度投影(maxi

2、mumintensityprojection，MIP)及容积再现技术(volumerepresentationtechnology,VRT),全部患者均行数字减影血管造影(digitalsubtractionangiography,DSA)检査。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

3、、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。［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［中图分类号］R445.2［文献标识码］B［文章编号］1673-9701(2018)02-0103-04［Abstract］Objecti

4、veToinvestigatethevalueofmulti-slicespiralCT(MSCT)angiographyintheevaluationofintrahepaticandextrahepaticveinsandarteriesinthepatientswithprimarylivercancer.MethodsAtotalof84patientswithprimarylivercancerconfirmedpathologicallyorclinicallyfromMay2010toAugust2016were

5、selectedandretrospectivelyanalyzed.Amongthem,53patientsweregiventhree-dimensionalenhancedmagneticresonanceangiography(MRA),71patientsweregivenMSCTangiographyand71patientsweregivenmaximumintensityprojection(MIP)andvolumerepresentationtechnology(VRT).Allpatientsweregi

6、vendigitalsubtractionangiography(DSA)examination.ThedifferenceoflevelAmanifestationsofintrahepaticandextrahepaticveinsandarteriesandportalveinswascomparedbetweenthethreemethods,andthenumberofcasesofportalveintumorthrombus,arteriovenousfistulaandbloodsupplywerecompar

7、edbetweenthethreemethods.ResultsExternalabdominalartery，portalveintrunk,primaryhepaticarteryandprimaryportalveincouldallbeclearlyshownbythethreekindsofexaminationmethods,andthedifferencewasnotstatisticallysignificant(P>0.05).Thesecondaryandtertiaryintrahepaticartery

8、andprimaryportalveinreachedtolevelA,andMRAandVRTwerelowerthanMIPandDSA，thedifferenceswerestatisticallysignificant(P<0.05),andthedifference