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目的探讨动态强化MRI在周围型胆管细胞癌(PPC)的诊断价值。材料与方法回顾性分析经手术及病理证实的28例PPC的MRI平扫及动态增强征象。28例均行常规T2WI、T1WI及脂肪抑制序列,均加动态增强MRI扫描。结果28例中19例动脉期边缘不规则环形轻、中度强化,门脉期及平衡期轻、中度向心性强化,延迟7分钟呈持续强化;5例动脉期肿块边缘不规则环形强化,门脉期、平衡期及延迟期肿块强化方式同动脉期;2例动脉期强化不明显,门脉期至平衡期整个瘤体呈渐进性同步中度强化;2例动脉期明显强化,门脉期、至延迟期强化程度呈逐渐退出。28例中12例肿瘤周围见大小不等的楔形强化区,7例瘤块所在肝叶门脉血管显示不清,2例门脉主干内见瘤栓。28例中MR平扫正确诊断9例(32·1%),平扫结合动态增强正确诊断24例(85%)。结论周围型胆管细胞癌的MRI征象有一定的特征性,动态强化特征对PCC的定性诊断有较大价值。
Objective To investigate the diagnostic value of dynamic enhanced MRI in peripheral cholangiocarcinoma (PPC). Materials and Methods Retrospective analysis of 28 cases of PPC confirmed by surgery and pathology were performed MRI plain scan and dynamic enhancement. Twenty-eight patients underwent conventional T2WI, T1WI and fat suppression sequences, all with dynamic contrast-enhanced MRI. Results In the 28 cases, 19 patients with irregular arterial phase were mild and moderately circumscribed, with mild and moderate concentric portal phase and moderate concen- tration, with a sustained enhancement of 7 minutes delay. In the 5 cases, The portal vein phase, balance phase and delayed phase mass enhancement mode were the same as arterial phase. The enhancement of arterial phase in 2 patients was not obvious. The entire tumor from portal phase to equilibrium phase was progressive and moderately intensified. The arterial phase was significantly enhanced in 2 patients, Period, to the delay of the strengthening of the gradual withdrawal. Twenty-eight of the 28 patients had tumors of varying size around the wedge-shaped area of enhancement. The hepatic portal vein of 7 patients with tumor mass was unclear, and 2 patients had tumor embolus in the portal vein. Of the 28 cases, 9 cases (32.1%) were correctly diagnosed by MR plain scan and 24 cases (85%) correctly by plain scan combined with dynamic enhancement. Conclusion The MRI features of peripheral cholangiocarcinoma have certain characteristics. The dynamic enhancement features are of great value in the qualitative diagnosis of PCC.