磁共振胰胆管成像对肝门部胆管癌的诊断价值

Diagnosis of hepatic hilar cholangiocarcinoma with MR cholangiopancreatography

【目的】评价磁共振胰胆管成像(MRCP)对肝门部胆管癌(HC)的诊断作用。【方法】分析47例HC的MRCP表现,对其不同表现进行分类,并与手术病理结果对比。【结果】MRCP对HC梗阻水平的定位准确性达97.9%(46/47),对HC病变范围确定的符合率为87.2%(41/47)。HC的MRCP表现包括狭窄、阻塞或充盈缺损。依据病理学分型,结节型、息肉型、硬化型和浸润型呈不同影像学表现。【结论】磁共振胰胆管成像可反映肝门部胆管癌的大体病理学特点,但对肝门部胆管癌定性诊断价值有限。MRCP对病变位置及病灶沿胆管向肝脏方向累及范围的确定较准确,对外科手术方案的制订具有重要作用。

【Objective】 To evaluate the value of magnetic resonance cholangio-pancreatography（MRCP） in the diagnosis of hilar cholangiocarcinoma（HC）.【Methods】 47 patients with pathologically proven HCs underwent MRCP and classified based on the MRCP findings,then put a comparative study between them.【Results】 The accuracy of MRCP in locating the obstructed level was 97.9%（46/47）.The coincidence of MRCP in determining the extent of HCs was 87.2%（41/47）.MRCP findings of HCs were overall showed obstruction,stenosis or filling defect.Based on pathology types,HCs can be divided into polypoid,nodular,sclerosing and infiltrative.【Conclusion】 MRCP can reflect the general pathological features of HCs,but has limited value in qualitative diagnosis.MRCP has a important role in surgical planning which could accurately find the scope of the disease and infiltracted bile duct.