肝门部胆管癌206例影像诊断分析

Comparative Analysis of Diagnostic Performance of Medical Imaging Mondalities in Hilar Cholangiocarcinoma

目的 :探讨 4种不同影像检查方法对肝门部胆管癌的诊断价值。材料与方法 :回顾性分析 2 0 6例肝门部胆管癌超声、CT、ERCP、PTC诊断结果及并发症 ,并与手术及病理结果对照。结果 :梗阻部位确诊率超声为 91 1% ,CT为 89 6 % ,二者联合为 97 3 %。梗阻性质确诊率超声为 78 7% ,CT为 72 8% ,二者联合为 94 7%。肿瘤显示率超声为 6 0 9% ,CT为 30 4% ,二者联合检查提高到 80 5 %。并发症发生率ERCP和PTC分别为 11 6 %及 17 9%。结论 :超声与CT联合检查可相互弥补不足 ,明显提高梗阻部位及梗阻性质确诊率 ,满足绝大多数肝门部胆管癌诊断要求 。

Purpose: To evaluate the diagnostic value of different imaging methods for hilar cholangiocarcinoma. Materials and Methods: The diagnostic efficacy and complication of varions imaging modalities were analyzed retrospectively in 206 patients with hilar cholangiocarcinoma. Results: The preoperative diagnostic rates of obstruction location were 91.1%, 89.6% and 97.3% for ultrasound, CT and US in combination with CT respectively. The etiology of the obstructioh were correctly identified in 78.7%, 72.8% and 94.7% cases by US, CT and combination of the two. Tumor were clearly revealed in 60.9%, 30.4% and 80.5% by US, CT and US in combination with CT. Complication rates were 11.6% and 17.9% for ERCP and PTC. Conclusion: ultrasonography in combination with CT had the best diagnostic efficacy in detecting location and nature of biliary obstruction thus met the needs of imaging diagnosis in most patients with hilar cholangiocarcinoma. The use of invasive technique such as ERCP and PTC should be as less as possible.