磁共振灌注成像在肝脏疾病中的临床应用

陈娟; 尹化斌

doi:10.3969/j.issn.1001-5256.2013.10.018

磁共振灌注成像在肝脏疾病中的临床应用

DOI: 10.3969/j.issn.1001-5256.2013.10.018

陈娟,
尹化斌

复旦大学附属上海市第五人民医院放射科

详细信息

中图分类号: R445.2
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出版历程
- 收稿日期: 2013-02-25
- 出版日期: 2013-10-20

Clinical application of perfusion- weighted MRI in liver diseases

Department of Radiology, Shanghai Fifth People's Hospital Affiliated to Fudan University

摘要

摘要: 常规磁共振检查可以反映腹部实体肿瘤的大小和形态特点,而灌注成像可以进一步了解肿瘤的血供、血管分布和血管通透性情况,有助于对肿瘤的诊断及鉴别诊断、恶性肿瘤的分期及肿瘤治疗效果的评价。简述了磁共振灌注成像的方法及常用分析指标,介绍了其在肝纤维化分期、肝肿瘤的鉴别诊断、隐匿性或微小肝转移灶的检测、肝癌或肝转移癌非手术治疗后效果观察等方面的应用现状,提出尽管磁共振检查在临床应用中受到患者身体状况等条件限制,但也具有无辐射损伤等优点,值得临床推广。
- 磁共振血管造影术 /
- 肝疾病
Abstract: Conventional magnetic resonance imaging ( MRI) can provide the characteristics of abdominal solid tumors such as sizes and shapes, while perfusion- weighted imaging can provide additional information on the blood supply, vascular distribution, and vascular permeability of tumors. These information is useful for diagnosis and differential diagnosis, tumor staging, and evaluation of treatment outcome.The procedures and common metrics of perfusion- weighted MRI are reviewed, and its applications in liver fibrosis staging, differential diagnosis of liver tumors, detection of occult or small liver metastases, and evaluation of non- surgical treatment outcome of liver cancer or metastasis are presented. It is suggested that greater effort is needed to promote the clinical use of MRI, as it causes no radiation damage, despite the fact that the use of MRI is subject to patient conditions.
- magnetic resonance angiography /
- liver diseases

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参考文献(30)

[1]JIA WX, CHEN M.Application of function magnetic resonance imaging[M].Peking:People's Military Medical Press, 2012:98-100. (in Chinese) 贾文霄, 陈敏.磁共振功能成像临床应用[M].北京:人民军医出版社, 2012:98-100.

[2]JIN N, DENG J, CHADASHVILI T, et al.Carbogen gas-challenge BOLD MR imaging in a rat model of diethylnitrosamine-induced liver fibrosis[J].Radiology, 2010, 254 (1) :129-137.

[3]LIN GW, ZHOU CW.The advancement of functional magnetic resonance imaging in tumor diagnosis and appreciation of curative effects of liver disease[J].Oncol Progr, 2007, 5 (5) :442-448. (in Chinese) 林光武, 周纯武.磁共振功能成像在肝脏疾病的诊断及疗效评价方面的应用进展[J].癌症进展, 2007, 5 (5) :442-448.

[4]KIM AY, KIM YK, LEE MW, et al.Detection of hepatocellular carcinoma in gadoxetic acid-enhanced MRI and diffusion-weighted MRI with respect to the severity of liver cirrhosis[J].Acta Radiol, 2012, 53 (8) :830-838.

[5]KOJIRO M, WANLESS IR, ALVES V, et al.Pathologic diagnosis of early hepatocellular carcinoma:a report of the international consensus group for hepatocellular neoplasia[J].Hepatology, 2009, 49 (2) :658-664.

[6]TAJIMA T, HONDA H, TAGUCHI K, et al.Sequential hemodynamic change in hepatocellular carcinoma and dysplastic nodules:CT angiography and pathologic correlation[J].AJR Am J Roentqenol, 2002, 178 (4) :885-897.

[7]PARENTE DB, PEREZ RM, EIRAS-ARAUJO A, et al.MR imaging of hypervascular lesions in the cirrhotic liver:a diagnostic dilemma[J].Radiographics, 2012, 32 (3) :767-787.

[8]MATSUI O, KOBAYASHI S, SANADA J, et al.Hepatocelluar nodules in liver cirrhosis:hemodynamic evaluation (angiography-assisted CT) with special reference to multi-step hepatocarcinogenesis[J].Abdom Imaging, 2011, 36 (3) :264-272.

[9]GUAN S, ZHAO WD, ZHOU KR, et al.Assessment of hemodynamics in precancerous lesion of hepatocellular carcinoma:Evaluation with MR perfusion[J].World J Gastroenterol, 2007, 13 (8) :1182-1186.

[10]RHEE H, KIM MJ, PARK YN, et al.Gadoxetic acid-enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria[J].J Magn Reson Imaging, 2012, 35 (2) :393-398.

[11]XU H, XIE JX, LI X, et al.Perfusion-weighted MRI in evaluating the intranodular hemodynamic characteristics of dysplastic nodules and hepatocellular carcinomas in an experimental rat model[J].J Magn Reson Imaging, 2008, 27 (1) :102-109.

[12]REN S, YE ZX, ZHU LM.Pathological and imaging features of multistep process of cirrhosis nodules[J].J Clin Hepatol, 2011, 27 (4) :425-428. (in Chinese) 任崧, 叶兆祥, 朱理珉.肝硬化结节多步癌变的病理及影像学表现[J].临床肝胆病杂志, 2011, 27 (4) :425-428.

[13]KUDO M.Diagnostic imaging of hepatocellular carcinoma:recent progress[J].Oncology, 2011, 81 (Suppl 1) :73-85.

[14]TSUSHIMA Y, BLOMLEY M, YOKOYAMA H, et al.Does the presence of distant and local malignancy alter parenchymal perfusion in apparently disease-free areas of the liver?[J].Dig Dis Sci, 2001, 46 (10) :2113-2119.

[15]LI ZG, HUANG JX, LI SZ, et al.Blood supply of liver metastasis[J].J Peking Univ:Health Sci, 2008, 40 (2) :146-150. (in Chinese) 李智岗, 黄景香, 李顺宗, 等.肝转移瘤的血供[J].北京大学学报:医学版, 2008, 40 (2) :146-150.

[16]DEZSO K, BUGYIK E, PAPP V, et al.Development of arterial blood supply in experimental liver metastases[J].Am J Pathol, 2009, 175 (2) :835-843.

[17]FIORENTINI G, ALIBERTI C, TILLI M, et al.Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer:final results of a phase III study[J].Anticancer Res, 2012, 32 (4) :1387-1395.

[18]KIM T, HORI M, ONISHI H.Liver masses with central or eccentric scar[J].Semin Ultrasound CT MR, 2009, 30 (5) :418-425.

[19]DONATI F, BORASCHI P, GIGONI R, et al.Focal nodular hyperplasia of the liver:diffusion and perfusion MRI characteristics[J].Magn Reson Imaging, 2013, 31 (1) :10-16.

[20]LEPORQ B, DUMORTIER J, PILLEUL F, et al.3D-liver perfusion MRI with the MS-325 blood pool agent:a noninvasive protocol to asses liver fibrosis[J].J Magn Reson Imaging, 2012, 35 (6) :1380-1387.

[21]KIM BH, LEE JM, LEE YJ, et al.MR elastography for noninvasive assessment of hepatic fibrosis:experience from a tertiary center in Asia[J].J Magn Reson Imaging, 2011, 34 (5) :1110-1116.

[22]ZENG Y, ZHAO JN, WU W, et al.Establishment of liver fibrosis in rabbit model and quantitative study on hepatic perfusion with dynamic whole-liver 3D MR imaging[J].Chin J Hepatol, 2009, 17 (5) :350-353. (in Chinese) 曾燕, 赵建农, 吴伟, 等.家兔肝纤维化模型的建立及三维全肝动态磁共振灌注成像对纤维化分期的量化价值[J].中华肝脏病杂志, 2009, 17 (5) :350-353.

[23]HAGIWARA M, RUSINEK H, LEE VS, et al.Advanced liver fibrosis:diagnosis with 3D whole-liver perfusion MR imaging-Initial experience[J].Radiology, 2008, 246 (3) :926-934.

[24]THNG CH, KOH TS, COLLINS DJ, et al.Perfusion magnetic resonance imaging of the liver[J].World J Gastroenterol, 2010, 16 (13) :1598-1609.

[25]HIRASHIMA Y, YAMADA Y, TATEISHI U, et al.Pharmacokinetic parameters from 3-Tesla DCE-MRI as surrogate biomarkers of antitumor effects of bevacizumab plus FOLFIRI in colorectal cancer with liver metastasis[J].Int J Cancer, 2012, 130 (10) :2359-2365.

[26]CAO Y, WANG HS, JOHNSON TD, et al.Prediction of liver function by using magnetic resonance-based portal venous perfusion imaging[J].Int J Radiat Oncol, 2013, 85 (1) :258-263.

[27]MIYAZAKI K, ORTON MR, DAVIDSON RL, et al.Neuroendocrine tumor liver metastases:use of dynamic contrast-enhanced MR imaging to monitor and predict radiolabeled octreotide therapy response[J].Radiology, 2012, 263 (1) :139-148.

[28]LARSON AC, WANG D, ATASSI B, et al.Transcatheter intraarterial perfusion:MR monitoring of chemoembolization for hepatocellular carcinoma-feasibility of initial clinical translation[J].Radiology, 2008, 246 (3) :964-971.

[29]CHEN Z, GUO Y, ZHENG XL, et al.Value of MR perfusion imaging after intervention treatment of hepatic cancer[J].ChineseGerman J Clin Oncol, 2009, 8 (1) :33-36.

[30]ZENG MS.The emphasizing MRI technology on application of liver-the clinical diagnostic value and advance of small hepatocellular carcinoma[J].Chin Comput Med Imag, 2011, 17 (5) :385-389. (in Chinese) 曾蒙苏.重视肝脏MRI技术应用——小肝癌临床诊断价值和进展[J].中国医学计算机成像杂志, 2011, 17 (5) :385-389.

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