MRI多序列扫描判定原发性胆囊癌组织病理学分期效能研究*

doi:10.3969/j.issn.1672-5069.2026.01.040

摘要/Abstract

摘要： 目的探讨应用MRI多序列检查术前判定原发性胆囊癌患者肿瘤分期的应用价值。方法 2022年3月～2025年3月我院收治的53例原发性胆囊癌患者均接受MRI常规和多序列扫描检查和手术切除治疗。术后取得组织病理学诊断肿瘤分期。结果在53例胆囊癌患者中,经术后组织病理学检查证实均为胆囊癌,其中Ⅰ期11例,Ⅱ期15例和Ⅲ期27例,低分化21例,中分化23例,高分化9例;肿瘤Ⅲ期胆囊癌病灶表观扩散系数(ADC)为(1.0±0.1),显著低于Ⅰ期胆囊癌病灶【(1.5±0.2),P<0.05】或Ⅱ期病灶【(1.2±0.2),P<0.05】,而不同分化程度的病灶ADC值之间无显著性差异(P>0.05);常规MRI判定胆囊癌Ⅰ期、Ⅱ期和Ⅲ期分别为10例、18例和25例,而多序列MRI判定为9例、18例和26例,诊断的准确率为90.6%,显著高于常规MRI诊断的67.9(P<0.05)。结论采用MRI多序列检查有助于提高术前对原发性胆囊癌肿瘤分期的判定,可指导手术方案的准确制定。

关键词: 原发性胆囊癌, 手术切除, 肿瘤分期, 磁共振成像, 扩散加权成像, 诊断

Abstract: Objective The aim of this study was to explore application of MRI multi-sequence scan in the preoperative diagnosis of tumor staging in patients with primary gallbladder cancer. Methods 53 patients with primary gallbladder cancer were encountered in our hospital between March 2022 and March 2025, and all had tumor resection after multi-sequence MR scan. The diagnosis was confirmed by post-operational histo-pathological examination. Results Of the 53 patients with primary gallbladder cancer, the pathological study found tumor stageⅠ in 11 cases, stage Ⅱ in 15 cases and stage Ⅲ in 27 cases, and low differentiation in 21 cases, middle differentiation in 23 cases and high differentiation in 9 cases; the apparent diffusion coefficient (ADC) in stage Ⅲ foci was (1.0±0.1), much lower than [(1.5±0.2), P<0.05] in stage Ⅰ or [(1.2±0.2), P<0.05] in stage Ⅱ, while there were no significant differences among different cell differentiation groups(P>0.05); conventional MRI diagnosed tumor stage Ⅰ, Ⅱ and Ⅲ in 10 cases, 18 cases and 25 cases, while they were 9 cases, 18 cases and 26 cases by multi-sequence MR scan, with the accuracy of 90.6%, much higher than 67.9(P<0.05) by conventional MRI. Conclusion Multi-sequence of MRI scan is beneficial to improve the diagnostic accuracy of the tumor staging in patients with primary gallbladder cancer, which might help surgeons make an appropriate operation plan preoperatively.

Key words: Primary gallbladder cancer, Surgical resection, Tumor stage, Magnetic resonance imaging, Diffusion-weighted imaging, Diagnosis

鞠金宏, 卢贺峰, 周杨. MRI多序列扫描判定原发性胆囊癌组织病理学分期效能研究^*[J]. 实用肝脏病杂志, 2026, 29(1): 157-160.

Ju Jinhong, Lu Hefeng, Zhou Yang. Application of MRI multi-sequence scan in the preoperative diagnosis of tumor staging in patients with primary gallbladder cancer[J]. Journal of Practical Hepatology, 2026, 29(1): 157-160.

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MRI多序列扫描判定原发性胆囊癌组织病理学分期效能研究^*

Application of MRI multi-sequence scan in the preoperative diagnosis of tumor staging in patients with primary gallbladder cancer

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