中文摘要：

目的：探讨计算机辅助MRI三维重建在肝转移瘤微波消融术前计划及术后随访中的作用。方法：2015年8月至2016年5月我院收治符合肝微波消融适应证的肝转移瘤患者16例（21个病灶）。术前采用MRI及后处理站进行多维度、多序列（T1WI增强、T2WI及DWI）3D重建观察目标病灶及周围环境，综合多方面因素考虑制订术前穿刺及消融计划；术中实时利用3D重建技术，以垂直于穿刺针平面进行实时追踪并评估穿刺途径及消融范围，术后采用同一平面利用T2WI、T1WI增强及DWI成像评估术后消融范围及效果。结果：手术均顺利完成，无明显并发症，随访至术后1～3个月未见明显复发征象。其中14例术前行肝脏CTA检查（检出病灶17个），与CTA相比，TIWI-MRI3D重建显示病灶周边血管（三级及三级以上分支）为29／30，显示率为99％；所有病例未见明显胆管扩张，术前T2WI显示病灶邻近lcm内二级胆管分支共12例。根据术前规划、模拟穿刺途径，与实际穿刺途径符合100％，术后3D重建显示消融范围完全覆盖肿瘤边界。结论：计算机辅助MRI评价体系可有效评价目标病灶的大小及周边环境，为术前拟定手术方案提供依据；术中可有效引导穿刺并实施多维度展现术区变化，评估消融范围；术后及随访可有效多序列展示消融边界及信号变化，提供多方位信息。

英文摘要：

Purpose： To verify the feasibility of MRI three-dimensional （3D） reconstruction in planning and evaluating the treatment response of liver metastasis microwave ablation （MWA）. Methods： From Aug 2015 to May 2016, according to the selection criteria, 16 patients （21 lesions） were enrolled. MRI exam （T1WI, T2WI, multi-b value DWI） were performed before the operation and also for the follow-up. All data were transferred to the workstation, and post-procession was done. Results： Till 1-3 month after operation, no serious or fatal complication, no recurrence was observed. The operation trace was 100% matched with the 3D reconstruction planning. Compared with CTA, 99% （29/30） small vessels were shown by MRI. No biliary duct dilation was shown in all cases; MRI showed 12 normal biliary ducts. PostSoperation signal change and ablation margin were shown by MRI 3D reconstruction. Conclusion： MRI 3D reconstruction is feasible and effective in the treatment planning and evaluating the treatment response of MWA for liver metastasis.