3.0T磁共振LAVA动态增强联合MRCP诊断肝外胆管癌

The Application of Combining 3.0T MRI Dynamic Enhancement and MRCP in the Diagnosis of Extrahepatic Cholangiocarcinoma

目的探讨3.0TMRILAVA动态增强联合MRCP在肝外胆管细胞癌诊断中的临床应用价值。方法回顾性分析经病理证实的25例肝外胆管细胞癌资料。所有患者均在常规MR扫描基础上行MRCP检查及LAVA多期动态增强扫描,观察病变征象并与病理结果对照。结果 25例患者均经病理证实,包括肝门区胆管癌17例、胆总管中段癌3例,胆总管下段癌5例,本组病灶中1例肝门区胆管癌漏诊,分别有2例肝门区胆管癌和1例胆总管下段癌误诊为炎症,诊断准确率为83.3%。病灶定位诊断中,分别有l例胆总管下段癌误诊为壶腹癌和胰头癌,病变组织起源诊断准确度为88%。结论高场磁共振LAVA动态增强和MRCP技术的联合应用能为肝外胆管癌的早期诊断、鉴别诊断提供重要信息,具有很高的临床应用价值。

Objective To explore the value of combining 3.0T MRI dynamic enhancement and MRCP in the diagnosis of extrahepatic cholangiocarcinoma.Methods MR data of 25 cases with extrahepatic cholangiocarcinoma proved pathologically were retrospectively analyzed.MRCP and multi-phase dynamic enhancement were performed following conventional MRI scans.The manifestations were reviewed and compared to the pathology.Results Pathological diagnoses of 25 cases were 17 cases of hilar cholangiocarcinoma,3 cases of intermediate cholangiocarcinoma,5 cases of distal cholangiocarcinoma.1 case of hilar cholangiocarcinoma was missed.2 cases of hilar cholangiocarcinoma and 1 case of distal cholangiocarcinoma were misdiagnosed as inflammations.The diagnostic accuracy rate of qualitation was 83.3%.1 case of distal cholangiocarcinoma was misdiagnosed as ampullary carcinoma and carcinoma of head of pancreas respectively.The diagnostic accuracy rate of location was 88%.Conclusions High field MRI dynamic enhancement combined with MRCP can play an important role in early diagnosis and differential diagnosis of extrahepatic cholangiocarcinoma.