MRCP结合LAVA动态增强磁共振对肝外胆管癌诊断价值

The Diagnostic Value of MRCP Combined With LAVA Dynamic Enhancing Magnetic Resonance in the Diagnosis of Extrahepatic Bile Duct Carcinoma

目的探究MRCP结合LAVA动态增强磁共振对肝外胆管癌诊断价值。方法回顾该院2013年12月1日—2015年6月1日之间收治的52例手术病理证实的肝外胆管癌的患者,进行MRI常规扫描和MRCP结合LAVA动态增强磁共振检查,并进行对比,观察患者肝外胆管癌形态学特征以及生长部位等情况。结果 MRCP结合LAVA动态增强磁共振32例患者全部检查检出率为100%,MR常规扫描检出率为81.25%,两者比较,差异有统计学意义(P<0.05)。52例患者均可见显著的胆管扩张,呈弥漫性柱形、串行;肝内胆管呈现"蟹足状、软藤状"等。肝外胆管癌中发生于近段者27例,发生于远段者20例,另5例发生于近段及远段上部。结论 MRCP结合LAVA动态增强磁共振比MRI扫描具有较大的优势,不仅检出率高于常规MRI扫描,同时能够清晰地显示浸润范围及病变的扩散,为肝外胆管癌的早期诊断提供了有利的依据,具有较高的临床诊断价值。

Objective To study the diagnostic value of MRCP combined with LAVA dynamic enhancing magnetic resonance in diagnosis of extrahepatic bile duct carcinoma. Methods 52 cases of patients with extrahepatic bile duct carcinoma con-firmed by surgical pathology treated in the hospital from December1,2013to June 1,2015 were selected and given MRI rou-tine scan and the examination of MRCP combined with LAVA dynamic enhancing magnetic resonance ,the morphological characteristics and growth site of patients with the extrahepatic bile duct carcinoma were compared and observed. Results The detection rate of MRCP combined with LAVA dynamic enhancing magnetic resonance of 32 patients was 100%,the de-tection rate of MR conventional scan was 81.25% and the difference was statistically significant （P〈0.05）. 52 patients had obvious bile duct dilatation, which was presented as diffuse columnar and serial; while the intrahepatic bile duct was pre-sented as ＂crab foot＂, ＂soft rattan＂, etc. 27 cases of extrahepatic bile duct carcinoma occurred in the proximal segment, 20 cases occurred in the distal segment and the other 5 cases occurred in the proximal and distal segments. Conclusion MRCP combined with LAVA dynamic enhancing magnetic resonance has a great advantage over MRI scanning, the detection rate of which was higher than that of conventional MRI scan, at the same time, it can clearly show the extent of invasion and the spread of the disease. And it provides a good basis for the early diagnosis of extrahepatic bile duct carcinoma and has a higher clinical diagnostic value.