臨牀消化器内科 Vol.17 No.1(3-2)


特集名 肝の画像診断
題名 MRI (2) 肝におけるガドリニウム造影3D-MR angiographyの有用性
発刊年月 2002年 01月
著者 北村 敬利 山梨医科大学第1内科
著者 市川 智章 山梨医科大学放射線科
著者 岡田 俊一 山梨医科大学第1内科
著者 赤羽 賢浩 山梨医科大学第1内科
著者 藤野 雅之 山梨医科大学第1内科
【 要旨 】 ガドリニウム造影3D-MR angiographyは,非常に短いTR/TEを用いることで,造影剤のT1短縮効果のみを画像化する撮像法である.結節,血管系の描出に優れ,肝細胞癌などの多血性結節の描出では,従来のdynamic MRIやhelical CTとほぼ同等の診断能をもつ.DSA同様の画像が得られるため,DSAでの腫瘍濃染像出現位置の予測やその栄養血管の同定,血管破格の描出に有用である.また,腹腔内の血管を広範囲に描出できるため,側副血行路の診断に有用である.侵襲性が低いことから,繰り返しての検査が可能で,治療効果判定に有用である.
Theme Imaging Diagnostics of Liver Disease
Title Contrast-enhanced 3D-MR Angiography in Diagnosis of Liver Disease
Author Takatoshi Kitamura 1st Department of Medicine, Yamanashi Medical University
Author Tomoaki Ichikawa Department of Radiology, Yamanashi Medical University
Author Syunichi Okada 1st Department of Medicine, Yamanashi Medical University
Author Yoshihiro Akahane 1st Department of Medicine, Yamanashi Medical University
Author Masayuki A. Fujino 1st Department of Medicine, Yamanashi Medical University
[ Summary ] Contrast-enhanced three-dimensional MR angiography (CE-3D-MRA) is a promising method for evaluating patients with cirrhotic liver because it allows us to simultaneously obtain both arterial and portal-phase images. Arterial-phase images are useful for detecting HCC, while the portal-phase images are also useful for assessing collateral pathways in the patients. The detectability of HCC with arterial-phase CE-3D-MRA images was proved to be equivalent to those with arterial-phase conventional MR and helical CT images. Moreover, the efficacy of evaluating collateral pathways with coronal, portal-phase CE-3D-MRA images was the best among those of digital subtraction angiography (DSA), CT/MR images, and RI portography based on our results. As a result, we believe that CE-3D-MRA may have a potential to replace DSA as an invasive technique, at least which therapeutic procedures are not required for.
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