MR动态强化对周围型胆管细胞癌诊断价值的探讨

The Value of Dynamic Enchancement MR Imaging in the Diagnosis of Intrahepatic Peripheral Cholangiocarcinoma

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。

Purpose： To study the value of dynamic enchanced MR/ in tile diangosis of intrahepatic peripheral cholangiocarcinonra （PPC）. Materials and Methods;. Unenchanced and dynamic enchanced MR/findings of 28 patients proved surgically and pathmlogically were analyzed retrospectively. Exanfinaltion teclmiques T1WI and T2WI, T2WI fat - suppressed and dynamic enchanced T1WI were routinely performed in 28 patients. Results： In all 28 patients, artery phase irregularly gyrose light to moderate enhancement at the adge of the lesions and portal vein, balance phase light to moderate concentric enhancement and continuous enhancement in delay 7 minutes scanning were observed in 19 patients; Artery phase irregularly gyrose enhancement and portal vein, balance and delay phased had similar enhanced pattern with artery phase was seen in 5 patients; Artery phase without enhancement but portal vein phase to blance phase whole＇lesion progressive enhancement ws ween in 2 patients; Artery phased obviously enlmnced but portal vein phase to delay phase enhanced develepment progressive reducing was ween in 2 patients. In 28 patients, the wedge - like enhancement area around the tumor lesions was ween in 12 patients, portal vein of liver section that ttanor lesions occupyed showed unclear was seen in 7 patients; cancer plug in trunk portal vein was ween in 2 patients. In 28 patients, 9 patients （32.1 per） were diagnosed correctly by unenchanced MR/and 24 patients （85 per） tmenchanced MR/combined with dynamic enchanced MR/. Conclusion ： To some extent, the MR/feature of intrallepatic peripheral cholangiocarcinoma are characteristic, particulary, die characterist of dynamic enhanced MR/have more value in differential diagnosis of intrallepatic PCC.