MSCT、高场MR对肝转移瘤介入治疗的指导

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〈1cm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。

Guide on MSCT and high - field MR in the interventional treatment of hepatic metastases

Objective To discuss the guiding significance of MSCT and High - field MR in the interventional treatment of hepatic metastases（HMs）. Methods 21 cases HMs were treated by interventional treatment before it MSCT and High - field MR dynamic contrast- enhanced scanning and reconstruct angiography were performed first. Results High - field MR had higher detection rate of lesions than MSCT both in the plain scan and dynamic contrast - enhanced scan （ P 〈 0.05）. Vascular remodeling showed that all cases could show the hepatic artery three grade below through MSCTA, completely conformed to the DSA;14 cases were showed by MRA successfully, the 5 cases left couldn＇t show clearly because they couldn＇t cooprate with breathing well. Portal vein showed that all cases could show the branches of intrahepatic portal vein four grade below through MSCTA; MRA showed 13 cases successfully, the 3 cases left imaging too light that could not show the branches of intrahepatic portal vein four grade below, but most of the intrahepatic branches three grade below couldn＇ t show clearly. Conclusion MSCT and High - field MR could improve the detection rate of HMs, high - qulity imagy of hepatic artery and portal vein could be reconsructed by fast dynamic contrast - enhanced scanning, and compared with DSA, it had the advantage of operat more easily and non - invasive, so as be a guide in the interventional treatment of HMs.