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目的 探讨磁共振成像(MRI)及磁共振胰胆管成像(MRCP)在肝门部胆管癌诊断中的价值及对手术可切除性估价的指导意义。方法 回顾性分析20例肝门部胆管癌的MRI及MRCP影像特点,并与手术结果进行对照。结果 MRI18例在肝门区可见软组织肿块, 2例未见到肿块,仅表现肝内胆管扩张及管壁增厚。根据MRI与MRCP影像特点,对肝门部胆管癌的分型结果为:Ⅰ型3例,Ⅱ型4例,Ⅲ型6例,Ⅳ型7例,与术中所见对比符合率80%;对肿瘤可切除性进行术前评估,敏感度75%,特异度75%,诊断符合率80%。结论 MRI和MRCP联合应用有助于肝门部胆管癌的诊断、分型及手术可切除性的评估。
Objective To investigate the value of magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of hilar cholangiocarcinoma and its significance in evaluating the resectability. Methods The MRI and MRCP features of 20 hilar cholangiocarcinomas were retrospectively analyzed and compared with the surgical results. Results MRI18 cases showed soft tissue mass in the hilar region, no tumor in 2 cases, only intrahepatic bile duct dilation and wall thickening. According to the features of MRI and MRCP, the classification results of hilar cholangiocarcinoma were as follows: type Ⅰ in 3 cases, type Ⅱ in 4 cases, type Ⅲ in 6 cases and type Ⅳ in 7 cases. The coincidence rate was 80%. Tumor resectability was assessed preoperatively, with a sensitivity of 75% and a specificity of 75%. The diagnostic coincidence rate was 80%. Conclusion The combined application of MRI and MRCP is helpful for the diagnosis, classification and surgical resectability of hilar cholangiocarcinoma.