磁共振快速三维容积动态增强联合MRCP在肝外胆管癌患者中的诊断效果

Effect of Dynamic Enhancement of Magnetic Resonance Rapid Three-dimensional Volume Combined with MRCP in Diagnosis of Patients with Extrahepatic Bile Duct Carcinoma

目的探讨磁共振快速三维容积动态增强联合MRCP在肝外胆管癌患者中的诊断效果。方法方便选取2012年5月—2016年12月冠县人民医院收治肝外胆管癌患者52例,入组患者均经过手术病理检查最终得到确诊。入院后患者分别行磁共振快速三维容积动态增强和MRCP进行诊断,并且将诊断结果与手术病理结果进行比较,观察肝外胆管癌形态及生长情况。结果肝外胆管癌诊断检出率为100.00%,磁共振快速三维容积动态增强联合MRCP诊断检出率为96.15%,两种方法诊断检出率比较差异无统计学意义(P>0.05);肝外胆管癌生长部位相对较多,主要位于肝门区胆管,发生率为61.54%,其次为胆总管上段及壶腹部,均各占13.46%;(1)平扫。肝外胆管癌表现为肝门区肿块或胆管内大小出现不等的软组织结节。在常规DWI中所有病灶均为高信号;而整合了ASSET的DWI图像上,病灶信号更强。磁共振胰胆管成像下出现软藤样中-重度扩张,部分伴有胰管扩张。(2)LAVA动态增强。经过LAVA增强后肿瘤轻度强化,但是边界不清楚,临近胆管部位组织并未得到强化。结论肝外胆管癌患者采用磁共振快速三维容积动态增强联合MRCP诊断效果理想,能帮助患者及时确诊,能为临床治疗提供影像学依据,值得推广应用。

Objective To discuss the effect of dynamic enhancement of magnetic resonance rapid three-dimensional volume combined with MRCP in diagnosis of patients with extrahepatic bile duct carcinoma. Methods Convenient selection 52 cases of patients with extrahepatic bile duct carcinoma admitted and treated in our hospital from May 2012 to December 2016 were selected and confirmed by the operation pathology examination, and the patients were diagnosed with dynamic enhancement of magnetic resonance rapid three-dimensional volume and MRCP after admission, and the diagnostic results and operation pathological results were compared and the shape and growth situations of extrahepatic bile duct carcinoma were observed. Results The test rate of extrahepatic bile duct carcinoma was 100.0%, and the test rate of dynamic enhancement of magnetic resonance rapid three-dimensional volume combined with MRCP was 96.15%, and the difference was not statistically significant（P〈0.05）, and the growth site of extrahepatic bile duct carcinoma was relatively more, mainly in the cholangiocarcinoma at hepatic porta and the incidence rate was 61.54%, and upper segment and ampullar region of choledochal duct, respectively accounting for 13.46% and 13.46%.（1）Plain scan： the manifestation of extrahepatic bile duct carcinoma were masses in hepatic hilar region and different sizes of soft tissue nodules of choledochal duct, and all lesions were high signals in routine DWI, and the lesion signals were stronger on the DWI images with ASSET, and the ＂soft-canes-like＂ moderate-severe dilatation and some were with pancreatic duct dilatation.（2）LAVA dynamic enhancement, the tumors were mildly enhanced after LAVA enhancement, but the boundary was unclear, and the site next to bile duct was not enhanced. Conclusion The effect of magnetic resonance rapid three-dimensional volume combined with MRCP in diagnosis of patients with extrahepatic bile duct carcinoma is ideal, which can help patients confirmed in time and provide imaging basis for the clinical treatment, and it is worth promotion and application.