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1、第12卷第1期金陵医院学报Vol.12No.11999年2月BulletinofJinlingHospitalFeb.1999·11·原发性肝癌门静脉癌栓MRI和DSA比较朱锡旭陈自谦陈君坤南京军区南京总医院医学影像科(南京,210002)摘要目的:以血管造影表现作为诊断标准,用非侵入性磁共振成像(MRI)检查评价门静脉癌栓。方法:磁共振为1.0T超导系统,轴位扫描序列为SE序列T1权重和T2权重及小角度扫描法(FLASH)序列,数字减影血管造影术(DSA)为PhilipsC2000数字减影血管造影机,造影中采用减影技术。结果:20例原发性肝癌
2、伴有门静脉癌栓形成的DSA表现,13例门静脉癌栓腔内缺损MRI表现为异常信号取代正常的门静脉流空;4例门静脉闭塞表现为门静脉截断;3例门静脉弥漫性狭窄表现为门静脉不规则狭窄。结论:MRI敏感性高,特征性强,而且无创伤性。关键词肝肿瘤门静脉栓子MRI减影血管造影术中图法分类号R735.7对手术评价、预后判断和鉴别诊断有着重要意义。磁0引言共振成像(MRI)具有无创性、任意层面扫描及血管原发性肝癌常伴有门静脉癌栓形成,癌肿直接成像等优点。本研究比较20例原发性肝癌手术前门侵蚀静脉壁进而在静脉腔内生长形成癌栓,以阻塞静脉癌栓的MRI和血管造影表现,以
3、提高MRI诊门静脉血流。松脆的癌栓极易脱落,并随血流流入门断门静脉癌栓的准确性。静脉分支而导致门静脉内扩散。门静脉主干出现癌收稿日期:1997-02-04修回日期:1998-03-16栓一般不主张手术治疗,而肿瘤仅累及门静脉某个分支仍有手术切除的可能性。因此,门静脉癌栓形成3GeraghtyJG,CoreneyEC,SherryFetal.CA1523inpatients参考文献withlocoregionalandmetastaticbreastcarcinoma.Cancer,1992,70:28311张友会1现代肿瘤学1北京:北京医科大学
4、1中国协和医科大学4O’HanlonDM,KerinMJ,KentPJetal.Aprospectiveevaluation联合出版社,1993.223ofCA1523instageIcarcinomaofthebreast.JAmCollSurg,2O’DwyerPJ,DuffyMJ,O’SullivanFetal.CEAandCA1523in1995,180(2):210primaryandrecurrentbreastcancer.WorldJSurg,1990,14:565DetectionofplasmalevelsofCA15-3a
5、nddiscussionoftheirclinicalsignificanceinbreastcancerpatientsZhangMingDepartmentofGeneralSurgery,JinlingHospital(Nanjing,210002)AbstractObjectives:TostudytherelationshipbetweentheplasmalevelsandpositiveratesofcancerantigenCA1523andtumourprognosisfactors.Methods:Sixtybreastca
6、ncerpatientswithvariousclinicalphasesandpatologictypeswereselectedandmadeprospectivestudy,whoseplasmalevelsofCA1523weredetectedroutinelybyIRMA.Results:WefoundthatthereweresignificantdifferencesofCA1523inthosepatientswhohadecarcinomametastasistodifferentlymphnodesandremoteorg
7、nas.Duringpost2operationperiod,thetrendingobservationsofthemshowedthattherealsoweremorevisibledecreasesofCA1523thanthatofpre2operationandsharperincreasesofCA1523inlocalandanothersidebreastreoccurrencespatientsthanthatinsuvvivals.conclusions:WesuggestthattheplasmalevelsofCA15
8、23shouldbemea2suredperiodicallyasamorevalueablemeansofmornitoringoflocalreo
