肝内周围型胆管细胞癌的CT和MRI诊断研究

Diagnostic study of itrahepatic peripheral cholangioeareinoma by CT and MRI

目的探讨肝内周围型胆管细胞癌(IHPCC)的CT和MRI的诊断价值,以提高该病的诊断水平。方法回顾性分析32例IHPCC患者的CT和MRI影像学表现,并与手术或病理结果进行比较。结果 CT平扫肿块呈近似等密度或略低密度,早期强化明显者仅12例,延迟后内部不均匀强化29例。MRI显示T1WI低信号,T2WI不均匀高信号,30例早期边缘强化,延迟后内部不均匀呈向心性强化。联合诊断的符合率为93.8%,显著高于单独应用CT、MRI的符合率71.9%、75.0%,差异均有统计学意义(x2=5.40,4.64,P<0.05)。结论早期边缘强化,延迟后内部不均匀强化对于IHPCC诊断具有重要价值,临床上结合CT、MRI及临床实验室检查,可有效提高IHPCC早期诊断率。

Objective To investigate the diagnostic value of CT and MRI in detection of itrahepatic peripheral cholan gioeareinoma （IHPCC） so as to improve diagnostic accuracy of the condition. Methods The results of CT and MRI for 32 patients with IHPCC were analyzed retrospectively, and the results were compared with the finally obtained surgical-path- ological examination. Results CT non-enhanced scanning showed that the lesions of IHPCC was approximately equal den- sity or low density, peripheral enhancement in the early stage in 12 cases, delayed enhancement in the central regions of tumor in 2~ cases. MRI showed that low signal of Tl-weighted imaging （T1WI） and slightly increased non-uniform signal of T2-weighted imaging （T~ WI）. There were 30 cases of peripheral enhancement in the early stage and delayed endoeentric enhancement in the central regions of tumor. The diagnostic coincident rate of combination diagnosis （93.8 ~） was signifi- cantly higher than that ofCT （71.9%） and MRI （75.0%） （X2=5.40, 4.64, P〈0.05）. Conclusion Peripheral en- hancement in the early stage, delayed enhancement in the central regions of tumor are of great value for the diagnosis of IHPCC, and combination use of CT, MRI and laboratory tests clinically can effectively improve the early diagnostic rate.