肝门部胆管癌的磁共振诊断价值

Value of MRI on Diagnosing Hilar Cholangiocarcinoma

目的评价磁共振成像(MRI)及磁共振胰胆管造影(MRCP)在肝门胆管癌中的诊断价值。方法回顾分析22例经手术和病理证实的肝门部胆管癌患者的MRI及MRCP表现,以了解其影像特征和肿瘤的组织病理学特点。结果按肿瘤形态分:弥漫型16例,结节型4例,乳头型2例,22例肝门胆管癌均可见肝门肿块、肝内胆管扩张、肝门胆管中断,MRCP表现为阻塞、狭窄或充盈缺损;肿瘤侵及门静脉3例,表现为门脉侧壁浸润、门脉缩窄或闭塞。结论 MRI检查能较充分显示肝门胆管癌病变的大小、分型及其侵犯范围,对肝门胆管癌的诊断和鉴别诊断有重要价值,但对肿瘤侵犯血管估价尚有不足。

Objective To evaluate the diagnostic value of MRI and MRCP on hilar cholangiocarcinoma. Methods MRI and MRCP imaging as well as histopathologic features of 22 patients with hilar cholangiocarcinoma with surgical and pathological proofs were analyzed and studied retrospectively. Results Classifying according to configuration as below widespread type （ n = 16）, Tubercular type （ n = 4）, nipple type （ n = 2）. Hilar madd, dilatation of intrahepatic ducts and discontinuity of hilar biliary ducts occurred in all cases. The imaging of MRCP displayed obstruction, stenosis, and filling defects. Portal vein was invaded in 3 cases and presented as infiltration, stegnosis or occlusion of the vein. Conclusion MRI could show thoroughly the size, typing and encroaching range for hilar cholangiocarcinoma. It has higher value for the diagnosis and differential diagnosis of hilar cholangiocarcinoma. However, MRI is insufficient for the assessment of blood vessel encroachment.