The Application Of The Multi-Modal Image Technology In Liver Lesion

Part 1 The Application of Gd-EOB-DTPA enhanced MRI and MDCT in Hepatocellular CarcinomaPurpose:To explore the clinical application of Gd-EOB-DTPA enhanced MRI imaging in the detection,diagnosis and treatment of liver cancer.Methods:In our hospital of the medical records of 78 patients with hepatocellular carcinoma,who received curative liver resection from April 2012 to December 2016,were retrospectively analyzed.Including 50 males and 28 females with the average age of 49.7 years.Using MDCT and Gd-EOB-DTPA enhanced MRI image analysis the detection,diagnosis and treatment of liver cancer,we also investigated the change of therapeutic decision after adding Gd-EOB-DTPA-enhanced MRI to MDCT.Chi-square test or Fisher test analysis count data.P<0.05 was statistically significant.Result:GD-EOB-DTPA enhanced MRI examination identify all of the 93 lesions,Of the 93 lesions,81(81/93,87.1%)were confirmed by MDCT and Gd-EOB-DTPA enhanced MRI,12 HCCs were detected by Gd-EOB-DTPA enhanced MRI but not by MDCT,the average size was 1.15cm(0.5-1.9cm).There were 32 lesions with a diameter less than 2 cm,32(32/32,100%)were identified by Gd-EOB-DTPA enhanced MRI,20(20/32,62.5%)were confirmed by CT,Gd-EOB-DTPA enhanced MRI had higher detection than MDCT(p<0.01).there were 61 lesions with a diameter>2cm,all of them were identified by enhanced CT and Gd-EOB-DTPA enhanced MRI.78 HCC patients only MDCT examination,there were 47 patients(60.5%,47/78)were diagnosed typical HCC.After adding Gd-EOB-DTPA enhanced MRI to MDCT,the patients with typical HCC was increased from 47 to 72,and the coincidence rate was 92.3%(72/78),and the change rate of typical HCC was 32.0%(25/78).The rate of change in the therapeutic decision after adding Gd-EOB-DTPA enhanced MRI to MDCT was 15.4%(12/78).Conclusion:Gd-EOB-DTPA enhanced MRI imaging can help to improve the detection and diagnosis of hepatocellular carcinoma,and Gd-EOB-DTPA enhanced MRI can obtain more information before selecting HCC treatment decision.Part 2 Application of indocyanine green-fluorescent imaging technique in focal liver lesionsPurpose:To explore the clinical application of indocyanine green-fluorescent imaging technique imaging in focal liver lesions.Methods:In our hospital of the medical records of 31 patients with focal liver lesions,who received liver resection from March 2015 to September 2016,were retrospectively analyzed.Including 22 males and 10 females with the average age of 54.5 years.Indocyanine green-fluorescent imaging technique was used to detect the liver surfaces before resection,and identify the tumor,positioning,tumor size measurement,fluorescence classification,fluorescent nodules count.Result:There were 29 lesions were detected by ICG fluorescence on the liver surface,and 4 lesions were not detected by ICG fluorescence on the liver surface.After 33 lesions were removed,32 specimens were detected by ICG fluorescence,including 21 primary liver cancer,3 hepatic metastasis of colonic carcinoma,1 cirrhosis nodule,1 focal nodular hyperplasia,3 inflammatory nodules,3 cholangiocarcinomas,but there was 1 gastric stromal tumor no ICG fluorescence.In 21 patients with primary liver cancer,a total of 21 lesions,intraoperative use of ICG fluorescence imaging technology found 31 lesions.Conclusion:ICG imaging technology is helpful in the identification,localization and identification of liver tumors;and the detection of small hepatocellular carcinoma,satellite lesions and lymph nodes.