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1、第12卷第1期金陵醫(yī)院學(xué)報(bào)Vol.12No.11999年2月BulletinofJinlingHospitalFeb.1999·11·原發(fā)性肝癌門靜脈癌栓MRI和DSA比較朱錫旭陳自謙陳君坤南京軍區(qū)南京總醫(yī)院醫(yī)學(xué)影像科(南京,210002)摘要目的:以血管造影表現(xiàn)作為診斷標(biāo)準(zhǔn),用非侵入性磁共振成像(MRI)檢查評價(jià)門靜脈癌栓。方法:磁共振為1.0T超導(dǎo)系統(tǒng),軸位掃描序列為SE序列T1權(quán)重和T2權(quán)重及小角度掃描法(FLASH)序列,數(shù)字減影血管造影術(shù)(DSA)為PhilipsC2000數(shù)字減影血管造影機(jī),造影中采用減影技術(shù)。結(jié)果:20例原發(fā)性肝癌
2、伴有門靜脈癌栓形成的DSA表現(xiàn),13例門靜脈癌栓腔內(nèi)缺損MRI表現(xiàn)為異常信號取代正常的門靜脈流空;4例門靜脈閉塞表現(xiàn)為門靜脈截?cái)?3例門靜脈彌漫性狹窄表現(xiàn)為門靜脈不規(guī)則狹窄。結(jié)論:MRI敏感性高,特征性強(qiáng),而且無創(chuàng)傷性。關(guān)鍵詞肝腫瘤門靜脈栓子MRI減影血管造影術(shù)中圖法分類號R735.7對手術(shù)評價(jià)、預(yù)后判斷和鑒別診斷有著重要意義。磁0引言共振成像(MRI)具有無創(chuàng)性、任意層面掃描及血管原發(fā)性肝癌常伴有門靜脈癌栓形成,癌腫直接成像等優(yōu)點(diǎn)。本研究比較20例原發(fā)性肝癌手術(shù)前門侵蝕靜脈壁進(jìn)而在靜脈腔內(nèi)生長形成癌栓,以阻塞靜脈癌栓的MRI和血管造影表現(xiàn),以
3、提高M(jìn)RI診門靜脈血流。松脆的癌栓極易脫落,并隨血流流入門斷門靜脈癌栓的準(zhǔn)確性。靜脈分支而導(dǎo)致門靜脈內(nèi)擴(kuò)散。門靜脈主干出現(xiàn)癌收稿日期:1997-02-04修回日期:1998-03-16栓一般不主張手術(shù)治療,而腫瘤僅累及門靜脈某個(gè)分支仍有手術(shù)切除的可能性。因此,門靜脈癌栓形成3GeraghtyJG,CoreneyEC,SherryFetal.CA1523inpatients參考文獻(xiàn)withlocoregionalandmetastaticbreastcarcinoma.Cancer,1992,70:28311張友會(huì)1現(xiàn)代腫瘤學(xué)1北京:北京醫(yī)科大學(xué)
4、1中國協(xié)和醫(yī)科大學(xué)4O’HanlonDM,KerinMJ,KentPJetal.Aprospectiveevaluation聯(lián)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
