摘要
目的:探讨MSCT三期扫描及三维血管造影在肝移植受体术前评估的应用价值。方法:63例肝脏病人行动脉期、门静脉期和延迟期增强扫描(扫描时间为注射造影剂后22~25s、60s和120s,注射速率为3ml/s)。用VR法重建动脉期和门脉期血管,测量肝癌病灶大小、肝总动脉和腹腔动脉干直径,依据Michel’s标准对肝动脉分型。测量门静脉血栓的范围、肝脏容积,观察脾动脉瘤及静脉血管吻合情况。结果:63例中肝细胞肝癌15例(其中小肝癌3例),胆管癌2例,胆囊癌1例。Michels IX型肝动脉2例,腹腔干狭窄3例,脾动脉瘤2例,肝动脉细小2例。门静脉癌栓12例(长段癌栓7例)。肝脏平均容积为1114.41cm3。结论:MSCT三期扫描及三维血管造影能明确肝脏病变的性质,显示肝脏供血动、静脉解剖结构及病变,可测量肝脏的容积,能为肝移植受体提供综合的术前评估。
Abstract
Objective: To study the value of three-phase ce-MSCT with 3D-MSCTA(P) for evaluation of pre-operation of orthotopic liver transplantation candidates. Methods: Sixty-three potential candidates for liver transplantation were evaluated with three-phase ce-MSCT scanning(intravenous contrast medium was administered at the rate of 3ml/s. Three-phase scanning acquisition at 22~25s, 60s and 120s respectively after initiation of contrast medium injection). Arterial phase and portal venous phase scan information was used for volume rendering CTA(P). All images were analyzed to define the parenchymal liver disease and the size of hepatocellular carcinoma, as well as the diameter of common hepatic artery and celiac axis. The hepatic arterial blood supply was categorized according to Michel’s classification. Portal vein thrombosis was defined. Hepatic volume was measured by CT as well as collateralization stage of the hepatic venous system and splenic artery aneurysms. Results: Masses were pathologically proven as hepatocellular carcinoma in 15 cases(small hepatocellular carcinoma in 3 cases), cholangiocellular carcinoma in 2 cases, cholecystic carcinoma in 1 case in all of the 63 patients. Michels IX anatomy in 2 cases, celiac axis stenosis in 3 cases, small-caliber hepatic arterial vessels in 2 cases, SA aneurysms in 2 cases. Portal vein thrombosis in 12 cases?穴long segment in 7 cases), the mean hepatic volume was 1114.41cm3. Conclusions: Three-phase ce-MSCT with CTA(P) can define parenchymal liver disease, show the anatomy of hepatic artery and hepatic vein as well as vascular diseases, hepatic volume can be measured. MSCT can provide comprehensive preoperative liver evaluation for transplantation candidates.
关键词
肝硬化 /
肝肿瘤 /
肝移植 /
体层摄影术 /
X线计算机
Key words
liver cirrhosis /
liver neoplasms /
liver transplantation /
tomography /
X-ray computed
郭冬梅;边 杰;张秀丽.
肝移植术前MSCT评估[J]. 中国临床医学影像杂志. 2006, 17(6): 307-310
GUO Dong-mei;BIAN Jie;ZHANG Xiu-li.
MSCT evaluation of pre-operation of liver transplantation candidates[J]. Journal of China Clinic Medical Imaging. 2006, 17(6): 307-310
中图分类号：
R657.31
R735.7
R814.42
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