螺旋CT 和MRI 对肝内周围型胆管癌诊断价值分析

doi:10.3969/j.issn.1672-5069.2016.05.020

摘要/Abstract

摘要： 目的探讨螺旋计算机断层成像（CT）和磁共振成像（MRI）技术对肝内周围型胆管癌（IHPCC）的诊断价值。方法经病理学检查证实的80例IHPCC患者,均行螺旋CT和MRI平扫、增强和延迟扫描检查,比较影像学检查诊断的正确率。结果影像学上病灶为1.3 cm×2.0 cm~7.3 cm×9.0 cm （平均4.6 cm×6.4 cm）;位于肝左叶58例,肝右叶22例;呈肿块型46例（57.50%）、浸润狭窄型17例（21.25%）、腔内生长型10例（12.50%）、肿块不明确7例（8.75%）;CT平扫病灶呈略低密度,增强扫描时病灶分别呈轻中度的边缘强化50例、中央轻度条状或片状强化12例和无强化18例,延迟扫描时呈不均匀性片状或分隔状强化47例、均匀强化5例和无强化28例;MRI平扫较CT显示病灶更为清晰,延迟后73例病灶逐渐强化;MRI诊断正确率为91.3%,CT诊断正确率为80.0%,两者比较差异无统计学意义（P>0.05）。结论增强延迟扫描可提高螺旋CT和MRI诊断IHPCC的准确性,诊断IHPCC时可优先考虑行MRI检查。

关键词: 胆管癌, 计算机体层摄影术, 磁共振成像, 诊断

Abstract: Objective To evaluate the diagnosis of intrahepatic peripheral cholangiocarcinoma（IHPCC） by spiral computed tomography（CT） and magnetic resonance imaging（MRI）. Methods A total of 80 patients with IHPCC were included in this study. All patients underwent non-enhanced,enhanced,and delayed scanning of spiral CT and MRI examination,and the diagnostic efficacy were estimated by pathologic examination post-operationally or by fine needle biopsy before operation. Results The lesion size ranged from 1.3 cm×2.0 cm to 7.3 cm×9.0 cm （mean 4.6 cm×6.4 cm）;the tumors localized in left lobe in 58 cases,in right lobe in 22 cases;the tumors presented as mass in 46 cases （57.50%）,infiltrating stenosis in 17 cases （21.25%）,growth chamber in 10 cases （12.50%）,and not clear in 7 cases （8.75%）;Unenhanced CT scan showed low-density lesions in all,and enhanced CT scan showed mild to moderate edge enhancement in 50 cases,mild central strip sheet enhancement in 12 cases,and no enhancement in 18 cases;delayed CT scan showed separation of unevenness or sheet-like enhancement in 47 cases,homogeneous enhancement in 5 cases,and no enhancement in 28 cases;Unenhanced MRI scan showed the lesions more clearly than CT,and delayed enhanced MRI scan showed enhancement in 73 cases;the diagnostic accuracy rate of MRI was 91.3%,no statistically significant difference as compared to 80.0% by CT scan（P>0.05）. Conclusions Delayed enhanced CT and MRI scan may improve the diagnostic accuracy of IHPCC, and we recommend MRI in clinical practice.

Key words: Cholangiocarcinoma, Computed tomography, Magnetic resonance imaging, Diagnosis

刘振国, 强永乾. 螺旋CT 和MRI 对肝内周围型胆管癌诊断价值分析[J]. 实用肝脏病杂志, 2016, 19(5): 591-594.

Liu Zhenguo, Qiang Yongqian.. Diagnosis of intrahepatic peripheral cholangiocarcinoma by spiral CT and MRI[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(5): 591-594.

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