超声、MRCP及CT在肝门部胆管癌术前评估中的价值

Effect of Ultrasound,MRCP and Multi-slice Spiral CT on Preoperative Evaluation for Patients with Hilar Cholangiocarcinoma

目的研究超声、MRCP、双期CT在肝门部胆管癌术前评估中的应用价值。方法对18例肝门部胆管癌患者进行超声、MRCP、双期CT检查,MRCP判断肝内胆管侵犯情况,CT判断肝动脉和门静脉侵犯情况。利用上述结果进行Bismuth-Corlette分型和T分期。术前评估与手术结果进行对比。结果18例患者均成功进行超声、MRCP、双期CT检查,MRCP对17例肝门部胆管癌术前Bismuth-Corlette分型准确;3例肝动脉系统侵犯患者,2例超声或CTA结果与手术探查一致;4例门静脉系统侵犯患者,3例一致。17例T分期术前评估结果与手术探查一致。结论超声、MRCP结合CTA检查,可作为肝门部胆管癌术前评估的常规方法,其应用价值值得进一步的研究。

Objective To study the value of uhrasbund, MRCP and multl-sllce spiral CT to preoperative evaluation of patients with hilar cholangiocarcinoma. Methods Ultrasound,MRCP and dual-phase contrast CT scanning were performed in 18 cases with hilar cholangiocarcinoma,the condition of tumor invading in hepatic artery,portal vein and bile duct were observed. Preopera- tive Bismuth-Corlette classification and T-Staglng were recorded and compared with surgical exploration. Results Ultrasound, MRCP and CT were performed successfully for all 18 patients. Bismuth-Corlette classification of 17 cases with MRCP was diag- nosed correctly comparing to surgical exploration. Among 3 hepatic artery invasion patients detected by CT or ultrasound,two pa- tients＇ results were consistent with the results of surgical explorations. Three cases detected by CT or ultrasound in 4 portal vein invasion were consistent with surgical explorations. Preoperative T-Staging was almost consistent with surgical exploration. Con- clusions Ultrasound, MRCP and CT can evaluate hilar cholangiocarcinoma preoperatively as routine examination. Their useful- ness in the guidance of clinical therapy or operation deserves further investigation.