厚壁型胆囊癌与慢性胆囊炎的多层螺旋CT鉴别诊断

The differential diagnosis of thick-wall gallbladder carcinoma and chronic cholecystitis with multiple detector spiral computed tomography

目的探讨多排螺旋CT在厚壁型胆囊癌(TWGC)与慢性胆囊炎(CC)鉴别诊断中的价值,提高胆囊癌的诊断水平。方法收集经病理证实的TWGC 28例、CC 50例,随机编号,采取双盲法由3名高年资影像诊断专家在统一判定标准下独立完成诊断,遇诊断不一致时以2名专家为最终诊断。结果 MSCT诊断TWGC29例,CC 49例,误诊3例,漏诊2例。其中误诊的3例为黄色肉芽肿性胆囊炎,2例漏诊为CC。结论该判定标准诊断TWGC的灵敏度为0.93,特异度为0.94,阳性似然比为15.50,阴性似然比为0.07,阳性预测值为0.90,阴性预测值为0.96。该CT判定标准有助于鉴别TWGC与CC。

Objective To evaluate the value in the differential diagnosis of thick-wall gallbladder carcinoma （TWGC） and chronic cholecystitis （CC） with multiple detector spiral CT. Methods Collect 28 cases with TWGC and 50 cases with CC proved by operation and pathology, which were numbered randomly, then take a double-blind method by making diagnosis independently under the unified standard by three senior radiologists, when the diagnosis was inconsistent, the final diagnosis could be made by the two experts′ negotiation. Results With the unified stan-dard, 29 cases were diagnosed as TWGC and 49 cases as CC, including 3 cases being misdiagnosed with yellow gran-ulomatous cholecystitis and missed diagnosis in 2 cases of TWGC. Conclusion The sensitivity of the standard for di-agnosis of TWGC is 0.93, specific degree is 0.94, the positive likelihood ratio is 15.50, the negative likelihood ratio is 0.07, positive predictive value is 0.90, and the negative predictive value is 0.96. CT unified standard is helpful for i-dentifying TWGC and CC.