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目的探讨磁共振肝脏容积加速采集(LAVA)增强血管成像在肝脏巨大肿瘤切除术中的应用价值。方法对2011年1月至2012年10月中国人民解放军第81医院收治的31例行肝脏肿瘤切除术术前行磁共振LAVA动态增强的临床资料进行分析,行多平面(MPR)血管重建,测量预保留肝脏的体积,评估肝脏肿瘤切除的可行性,并分析手术前后肝功能变化。结果磁共振血管造影(MRA)显示所有病人肝动脉、门静脉和肝静脉及主要分支以及与肿瘤的关系,10例行半肝切除术,7例行肝叶切除术,9例行肝段切除术,5例楔形切除术。10例半肝切除病人预保留肝体积为38%~84%。31例术后均存活,93.5%(29/31)术后1周恢复肝功能。结论 LAVA增强检查能够准确显示肿瘤和血管关系,结合测量预留肝脏体积,对术前方案的制定具有重要作用。
Objective To investigate the value of magnetic resonance angiography (LAVA) enhanced angiography in the treatment of massive liver tumor resection. Methods From January 2011 to October 2012, 81 patients undergoing liver tumor resection were enrolled in the 81st Hospital of Chinese People’s Liberation Army underwent dynamic enhancement of magnetic resonance LAVA clinical data analysis, multiplanar (MPR) revascularization, measurement The volume of the liver was reserved, the feasibility of resection of the liver tumor was evaluated, and the changes of liver function before and after operation were analyzed. Results Magnetic resonance angiography (MRA) showed the relationship between hepatic artery, portal vein and hepatic veins, major branches and tumor in all patients. Hepatic resection was performed in 10 cases, hepatectomy in 7 cases and hepatectomy in 9 cases , 5 cases of wedge resection. 10 cases of hemihepatectomy patients with preoperative retention of liver volume was 38% to 84%. All the 31 cases survived, and 93.5% (29/31) recovered their liver function one week after operation. Conclusion LAVA enhanced examination can accurately show the relationship between tumor and blood vessels, combined with the measurement of the volume of the liver reserve, the formulation of preoperative programs play an important role.