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中华结直肠疾病电子杂志

中华结直肠疾病电子杂志 ›› 2016, Vol. 05 ›› Issue (05) : 386 -389. doi: 10.3877/cma.j.issn.2095-3224.2016.05.004

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结直肠癌肝转移影像诊断策略
邱大胜1,†()   
  1. 1. 430079　湖北省肿瘤医院PET/CT中心
  • 收稿日期:2016-06-18 出版日期:2016-10-25
  • 通信作者: 邱大胜

Diagnostic imaging strategies for colorectal liver metastases

Dasheng Qiu1,†()   

  1. 1. PET/CT Center, Hubei Cancer Hospital, Wuhan 430079, China
  • Received:2016-06-18 Published:2016-10-25
  • Corresponding author: Dasheng Qiu
  • About author:
    Corresponding author: Qiu Dasheng, Email:
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邱大胜. 结直肠癌肝转移影像诊断策略[J]. 中华结直肠疾病电子杂志, 2016, 05(05): 386-389.

Dasheng Qiu. Diagnostic imaging strategies for colorectal liver metastases[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2016, 05(05): 386-389.

超声、CT、MRI、PET/CT及PET/MR在结直肠癌肝转移诊治中广泛应用，NCCN指南提出结直肠癌肝转移影像学诊断首选增强MR，但对于每个结直肠癌肝转移患者如何选择合适的影像学检查，充分合理地应用有限的资源是临床关注的重点。结合国内外文献及笔者多年的MDT经验，对于结直肠癌肝转移患者，在参照指南的基础上更要结合患者自身病情，由多学科专家讨论做出合理的影像诊断。

关键词: 结直肠肿瘤, 肿瘤转移, 肝, 影像学诊断

Ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography CT (PET/CT) and positron emission tomography MR (PET/MR) are widely used in the diagnosis and treatment of colorectal liver metastases (CRCLM). Contrast-enhanced MR was the first choice in diagnosis of CRCLM by NCCN guidline. But it is important to choose the appropriate imaging modalities for each patient with CRCLM, and rationally use the limited medical resource.Combined with the literature and the authors experience in MDT. On the basis of reference to guidline and combined the patient′s own conditions, it could made reasonable decisions by multidisciplinary experts discussion for patients with liver metastases from colorectal cancer.

Key words: Colorectal neoplasms, Neoplasm Metastasis, Liver, Imaging diagnosis
图1 72y/F，直肠癌术后肝转移SIEMENS 3.0TMR成像仪，平扫、Gd-DTPA-增强及DWI，层厚6.5 mm，层间距0.5 mm。图1A、1B：T1WI（TR 120 ms，TE 2.46 ms），T2WI（TR 3000ms，TE 110ms），肝右后下段（VI段）可见两枚稍长T1稍长T2信号小结节，最大径分别为1.1 cm、0.7 cm；图1C：增强第VI较大结节呈环状强化，小结节增强强化不明显；图1D：DWI（TR 6700 ms，TE 93 ms，b=700 s/mm2）可见稍高信号结节（如白色箭头所示）
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