Yin Long-Lin, Song Bin, Li Ying-Chun, Chen Xian, Li Chang-Xian, Zhong Ke-Xiang, Sun Jia-Yu, Li Zhen-Lin
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2006 Nov;37(6):928-33.
To explore the diagnostic value of the system serial of three-dimensional spoiled gradient-echo T1-weighted MR imaging (three-dimensional volumetric interpolated breath-hold examination, 3D-VIBE) used to the preoperative assessment of hepatic portal cholangiocarcinoma.
31 surgically confirmed patients with hepatic portal cholangiocarcinoma underwent the preoperative examination through MR imaging system serial that was including T2W, two dimension (2D) T1W plain scan, 2D magnetic resonance cholangiopancreatography (MRCP), and Gadolinium-enhanced 3D-VIBE triple-phase dynamic acquisitions followed by 2D T1W scanning at the equilibrium phase. Meanwhile, it was performed for focusing on assessing or judging the tumor morphological type, the longitudinal infiltration extent of the bile duct and the involvement of neighbor blood vessels. And the 3D-VIBE was compared with 2D T1W systems for assessing or judging the tumor resectability.
(1) (3D-VIBE directly displayed the hepatic portal tumors and correctly classified the tumor morphological types in all patients, but 2D T1W systems missed to show 8 hepatic portal cholangiocarcinoma of periductal-infiltrating type (25. 8%); (2) According to Bismuth-Corlette classification, 3D-VIBE was closed to MRCP in accuracy (93.5%) for showing the longitudinal infiltration extent of tumor, but 2D T1W system serial underestimated (32.3%) the extent. (3) 3D-VIBE showed more involvement of the main trunk of hepatic artery, portal vein and their branches than 2D T1W systems did. (4) The positive predicting value and accuracy for assessing tumor resectability were 84.0% and 90.0% for 3D-VIBE system, as 64.0% and 71.0% for 2D T1W systems.
3D-VIBE system is superior to other MR imaging system serial in the preoperative assessment of the morphological type, the longitudinal infiltration extent and the tumor resectability of hepatic portal cholangiocarcinoma.
探讨三维扰相梯度回波T1加权磁共振成像序列（三维容积内插屏气检查，3D-VIBE）用于肝门部胆管癌术前评估的诊断价值。
31例经手术证实的肝门部胆管癌患者接受了磁共振成像序列的术前检查，包括T2加权成像、二维（2D）T1加权平扫、二维磁共振胰胆管造影（MRCP）以及钆增强3D-VIBE三相动态采集，随后在平衡期进行二维T1加权扫描。同时，重点评估或判断肿瘤形态类型、胆管纵向浸润范围及邻近血管受累情况。并将3D-VIBE与二维T1加权成像序列在评估或判断肿瘤可切除性方面进行比较。
（1）3D-VIBE能直接显示肝门部肿瘤并正确分类所有患者的肿瘤形态类型，但二维T1加权成像序列漏诊了8例导管周围浸润型肝门部胆管癌（25.8%）；（2）根据Bismuth-Corlette分类，3D-VIBE在显示肿瘤纵向浸润范围的准确性（93.5%）上与MRCP相近，但二维T1加权成像序列低估了浸润范围（32.3%）；（3）3D-VIBE显示肝动脉、门静脉主干及其分支受累情况比二维T1加权成像序列更多；（4）3D-VIBE系统评估肿瘤可切除性的阳性预测值和准确性分别为84.0%和90.0%，二维T1加权成像序列分别为64.0%和71.0%。
在肝门部胆管癌的形态类型、纵向浸润范围及肿瘤可切除性的术前评估中，3D-VIBE序列优于其他磁共振成像序列。
