[Three-dimensional reconstruction and image fusion between liver focal lesions and dynamic contrast-enhanced magnetic resonance angiography].

Background & Objectives: Identifying the correlation of focal lesions to the liver vessel system is a key factor in selecting treatment patterns for focal hepatic diseases. This study was to evaluate the feasibility of 3-dimensional reconstruction and the fusion image between the 3-dimensional dynamic contrast-enhanced magnetic resonance angiography (3D DCE MRA) and the focal hepatic lesions, and further, explore the clinical application of this method.
Methods: 3D DCE-MRA and conventional magnetic resonance imaging (MRI) were performed. The angiography and focal hepatic lesions were reconstructed with maximum intensity projection (MIP) and surface shaded display (SSD), and then fused together. Of the 25 cases with evaluable images, 2 were hemangioma, 3 were focal nodular hyperplasia, 1 was hepatocellular adenoma, 2 were macroregenerative nodule, 2 were hepatobiliary cystadenocarcinoma, and 17 were hepatocellular carcinoma; 21 were confirmed by operation resection, and 4 received digital subtraction angiography (DSA).
Results: The anatomic relationship between the lesions and the vessels were well shown. Of the 27 cases, 5 showed normal vessel branching, 6 showed feeding arteries from the hepatic artery, 11 showed compressed and shifted trunks of the vessels, 6 showed tumor invaded vessels, and 11 showed the tumor embolism in the portal vein or the inferior vena cave; 9 also showed MRI signs of portal hypertension. MIP was prior to SSD in demonstrating small branches of the hepatic vessels.
Conclusion: The 3-dimensional reconstruction and fusion images between 3D DCE-MRA and the focal hepatic lesions by using MIP and SSD can easily display the anatomic relationship between the focal hepatic lesions and the hepatic vessels, and thus can help the surgeons to localize lesions, minimize operating time and decide the extent of surgical resection.