MRI对胆囊癌诊断、肿瘤分期及鉴别诊断价值

Value of MRI in diagnosis、staging and differential diagnosis gallbladder carcinoma

目的探讨胆囊癌的MRI表现、肿瘤分期和鉴别诊断。方法回顾性分析我院43例经手术病理证实为胆囊癌的MRI表现,并进行MR分期。结果厚壁型9例(20.9%,9/43),结节型8例(18.6%,8/43),肿块型26例(60.5%,26/43),病变平扫TIWI呈稍低信号32例,低信号1例,等信号10例,T2WI呈稍高信号35例,高信号8例,增强扫描均呈明显强化。病变临近脏器受侵27例,血管受侵7例,远处转移8例,MRI分期Ⅰ期6例,Ⅱ期10例,Ⅲ期17例,Ⅳ期10例,手术病理证实Ⅰ期5例,Ⅱ期11例,Ⅲ期15例,Ⅳ期12例。结论MRI是一种对胆囊癌诊断、分期及鉴别诊断的可靠的影像检查方法,对临床最佳诊疗方案的选择具有重要的意义。

Objective To study the Value of MRI in diagnosis、staging and differential diagnosis Gallbladder carcinoma.Methods A retrospective analysis was made on 21 cases with proved gallbladder carcinoma by pathology.Results In this group,there were 9 cases（20.9%,9/23）of the Thick wall type,8 cases（18.6%,8/43） of tubercle type,and 26 cases（60.5%,26/43） of mass type.On precontrast MRI,32 cases were slight hypointense,1 case was hypointense and 10 cases were isointensity on TIWI,35 cases were slight hyperintense and 8 cases of hyperintens on T2WI..After gadolinium administration,43 lesions enhanced markedly.27 cases had infringed near organs,7 cases had infringed vessels and 8 cases had appeared distant metastases.There were 6 cases of stage Ⅰ,10 cases of stage Ⅱ,17 cases of stage Ⅲand 10 cases of stage Ⅳ by MRI,but through the operation confirmed,there were 5 cases of stage Ⅰ,11 cases of stage Ⅱ,15 cases of stage Ⅲand 12 cases of stage Ⅳ.Conclusion MRI is a kind of method to diagnosis、stage and distinguish gallbladder carcinoma,it has important significance in selecting therapeutic regimen.