磁共振VIBE增强扫描联合冠状位T_2WI诊断肝外远端胆管癌

Diagnostic Value of VIBE Enhancement Combined with Coronal T_2WI in Distal Extrahepatic Cholangiocarcinoma

目的探讨MR三维容积内插体部检查(volume interpolated body examination,VIBE)增强联合冠状位T2WI诊断肝外远端胆管癌的价值。方法 17例经手术病理证实的肝外远端胆管癌行MR冠状位T2WI、VIBE增强扫描,观察病灶的MR表现,测量病灶长度。结果 17例肝外远端胆管癌在冠状位T2WI上表现为肝外远端胆管梗阻,10例于胆管梗阻处见软组织肿块、3例见胆管壁增厚,同周围组织相比呈低信号。VIBE动态增强扫描17例病灶均呈进行性强化,10例肿块者中2例均匀性强化,8例肿块边缘强化更明显;7例胆管壁增厚、强化,在轴位VIBE图像上呈"环"形强化,在冠状位VIBE图像上,5例呈平行的"线条"状强化,2例呈"V"形强化。病灶平均长度为18.7 mm。结论 VIBE增强联合冠状位T2WI能较好地显示肝外远端胆管癌。

Objective To explore the clinical value of volume interpolated body examination（VIBE） enhancement combined with coronal T2WI in the diagnosis of distal extrahepatic cholangiocarcinoma.Methods Seventeen patients with distal extrahepatic cholangiocarcinoma proved by surgery and pathology were performed with MR coronal T2-weighted imaging and VIBE enhancement.The feature of lesions was recorded,and the length of lesions was measured.Results showed Distal bile duct obstruction were showed in all cases on coronal T2-wetighted images.Ten cases had mass and three cases had ductal wall thickening,all of which showed hypo-intensity compared with surrounding tissue.On VIBE enhancement images,all of lesions showed slowly and gradually enhancement.Two masses were homogeneous enhancement and eight masses were heterogeneous and rim enhancement.Seven cases showed ductal wall thickening and enhancement,which were rim enhancement on axis VIBE images,five were paralleled line and two were ＂V＂ shape enhancement on coronal VIBE images.The mean length of lesions was 18.7mm.Conclusion VIBE enhancement combined with coronal T2WI is an effective methods in the diagnosis of distal extrahepatic cholangiocarcinoma.