CT与MRI增强扫描诊断胆管癌临床分期价值分析*

doi:10.3969/j.issn.1672-5069.2026.05.036

摘要/Abstract

摘要： 目的分析计算机断层成像(CT)与磁共振成像(MRI)增强扫描和磁共振胰胆管成像(MRCP)技术评估胆管癌(CC)患者临床分期的诊断价值。方法 2023年10月～2025年6月我院收治的61例CC患者,均接受CT、MRI增强扫描和MRCP检查。以组织病理学检查诊断为金标准,应用Kappa检验分析CT和MRI检查诊断的一致性。结果在61例CC患者中,病理学检查诊断临床分期Ⅰ期10例,Ⅱ期15例,Ⅲ期19例和Ⅳ期17例; CT、MRI增强和MRCP联合检查诊断CC临床Ⅱ期的准确率为93.3%,显著高于CT检查的53.3%(P<0.05);联合诊断临床Ⅲ期的准确率为94.7%,显著高于CT、MRI增强或MRCP单独检查(分别为63.2%、68.4%和63.2%,P<0.05);联合诊断临床Ⅳ期的准确率为94.1%,显著高于CT、MRI增强或MRCP单独检查(分别为52.9%、64.7%和58.8%,P<0.05);在本研究41例肝门部胆管癌患者中,MRCP对Bismuth-CorletteⅠ型、Ⅱ型、Ⅲa型、Ⅲb型和Ⅳ型诊断的准确率为70.7%(29/41)。结论应用CT联合MRI和MRCP诊断CC患者临床分期的效能较高,可为CC术前精准分期、手术可切除性判断和个体化治疗方案的制定提供影像学依据。

关键词: 胆管癌, 临床分期, 计算机断层扫描, 磁共振增强成像, 磁共振胰胆管成像, 诊断

Abstract: Objective The aim of this study was to investigate diagnostic efficacy of computed tomography (CT) and magnetic resonance imaging (MRI) enhanced scans, including magnetic resonance cholangiopancreatography (MRCP), in clinical staging of patients with cholangiocarcinoma (CC). Methods 61 patients with CC were encountered in our hospital between October 2023 and June 2025, and they all received enhanced CT, MRI and MRCP examination before surgery. The diagnosis and tumor staging were proven by histopathological study. Diagnostic consistence was analyzed by Kappa. Results Of the 61 patients with CC, liver histopathological examination found clinical stage Ⅰ in 10 cases, stage Ⅱ in 15 cases, stage Ⅲ in 19 cases and stage Ⅳ in 17 cases; accuracy rate of CT combined with MRI and MRCP in the diagnosis of clinical stage II was 93.3%, much higher than 53.3%(P<0.05) by CT scan; accuracy rate of the three combination in the diagnosis of clinical stage Ⅲ was 94.7%, much higher than 63.2%, 68.4% and 63.2% (P<0.05) by CT, or MRI or MRCP alone; accuracy rate of the three combination in the diagnosis of clinical stage Ⅳ was 94.1%, much higher than 52.9%, 64.7% and 58.8% (P<0.05) by CT, or MRI or MRCP alone; of 41 patients with hilar CC, accuracy of MRCP in diagnosis of Bismuth-Corlette Ⅰ, Ⅱ, Ⅲa, Ⅲb and Ⅳ was 70.7%(29/41). Conclusion Clinical staging of patients with CC by enhanced CT, MRI and MRCP combination has a high diagnostic performance, which could provide a imaging basis for preoperative accurate tumor staging, surgical resectability assessment and individualized treatment strategy.

Key words: Cholangiocarcinoma, Clinical staging, Computed tomography, Enhanced magnetic resonance imaging, Magnetic resonance cholangiopancreatography, Diagnosis

王文轩, 李杰, 王馨蕊, 曹澍, 吴迪. CT与MRI增强扫描诊断胆管癌临床分期价值分析^*[J]. 实用肝脏病杂志, 2026, 29(5): 781-784.

Wang Wenxuan, Li Jie, Wang Xinrui, et al. Classification of cholangiocarcinoma staging by CT and MRI enhanced scans[J]. Journal of Practical Hepatology, 2026, 29(5): 781-784.

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CT与MRI增强扫描诊断胆管癌临床分期价值分析^*

Classification of cholangiocarcinoma staging by CT and MRI enhanced scans

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