肝门胆管癌的MDCT诊断及其术前评价

Multi-detector CT diagnosis and preoperative evaluation of hilar cholangiocarcinoma

目的探讨MDCT在肝门胆管癌术前评估中的价值。方法回顾经病理证实的肝门胆管癌31例，分析术前MDCT检查，观察肿瘤病灶大小、部位、强化方式、周围及远处侵犯情况、肝内胆管扩张以及肝脏、胆囊等改变，并与手术及术后病理结果对照。结果该组中MDCT定性诊断符合率达93．5％。77．4％的病例MDCT判断梗阻部位及Bismuth—Corlette分型与手术结果相符。MDCT判断分期与临床及TNM分期总的符合率为71．0％，Ⅰ期达100％。结论MDCT能够较好地检出肝门胆管癌和评价侵犯范围。有助于术前诊断及治疗方案的制定。

Objective To determine the value of multi-detector CT （MDCT） in the preoperative evaluation of hilar cholangioeareinoma. Methods Thirty one cases of hilar cholangiocarcinoma proved by histopathology were analyzed retrospectively. The MDCT scan was studied in order to observe the size, location, enhancement pattern of the lesions, extent of tumor involvement and indirect signs （such as the dilation of intrahepatic ducts and the changes of the liver and the gallbladder）. Finally, the resectability of hilar eholangiocarcinoma was evaluated. Results The coincidence rate of MDCT reached 93.5% in the diagnosis of hilar cholangiocarcinoma. Most cases （77.4%） were judged correctly in the location of obstruction by comparison with surgieohistopathology. The overall accuracy of MDCT in the estimation of TNM stages was 71.0%, while that of stage Ⅰ 100%. Conclusion MDCT can demonstrate the hilar cholangioeareinoma and assess the extent of tumor involvement. It is helpful in the preoperative diagnosis and the treatment planning.