肝内胆管细胞癌的CT和磁共振成像联合诊断价值

CT and MRI in the Combined diagnosis of intrahepatic cholangiocarcinoma

目的探讨分析CT、MRI及其影像后处理技术在肝内胆管癌诊断治疗中的联合应用价值。方法回顾性分析32例经病理确诊为肝内胆管癌患者的螺旋CT诊断结果和MRI诊断结果,对比分析两种诊断方式的差异、准确度和联合应用价值。结果 32例中27例行CT平扫及增强扫描均检出全部病灶,定位准确率为100%,定性准确率为77.78%(21/27),16例行MRI检查,定位准确率为100%,定性准确率为87.5%(14/16),MRI较MSCT更具优势,但MSCT成像速度快及对钙化敏感,亦成为某些特殊情况下本病的首选检查,结合CT多平面重组(MPR)及磁共振胰胆管造影(MRCP)进一步大大提高了本病的诊断符合率及治疗方法的合理选择。结论多排螺旋CT和磁共振在肝内胆管癌的诊断及治疗中均有较高的价值,在两者的基础上结合影像后处理技术准确率更高。

Objective To investigate the diagnostic value of multi-modality imaging（CT,MRI and reconstruction image） in intrahepatic cholangioearcinoma. Methods The CT and MRI findings of 32 patients with intrahepatic cholangioearcinoma confirmed by pathology were analyzed retrospectively and the diagnostic differences between CT and MRI were compared. Results Twenty-seven cases undergone CT scan and contrast enhancement and all of lesions were detectable. The location accuracy of lesion was 100% and qualitative identification rate was 77.8%. Sixteen cases were performed MRI examination and location accuracy,qualitative rate were 100%, 87.5% respectively. MRI was superior to CT in the aspect of qualitative diagnosis, but CT was sensitive to detect calcification and had a shorter scan time. Therefore, CT was the first imaging modality in some particular situation. Muhi-modality imaging can further increased diagnosis of agreement rate. Conclusion There was a convincing evidence that multi-modality imaging was better than single CT or MRI in diagnostic accuracy of intrahepatic cholangiocareinoma.