对比超声造影检查与MR增强扫描在肝内胆管癌诊断中的临床价值

Comparison on the clinical value of ultrasound contrast examination and MR-enhancement scan in the diagnosis of intrahepatic cholangiocarcinoma

目的:对比超声造影与MR增强扫描检查在肝内胆管癌诊断中的应用价值,并分析其灌注成像特征。方法:选取58例疑似肝内胆管癌患者,所有患者术前均接受超声造影检查以及MR增强扫描,观察肝内胆管癌的超声造影灌注特征以及MR增强征象。结果:58例疑似肝内胆管癌患者中经手术及组织病理学检验确诊为肝内胆管癌共51例;其中超声造影检查灵敏度为88.24%,特异度为42.86%,准确率为84.48%;MR增强扫描灵敏度为98.04%,特异度为57.14%,准确率为91.38%。动脉期超声造影灌注特征与MR增强征象比较无显著差异,门脉期与延迟期则存在差异,但无统计学意义(x^2=0.714,P>0.05);超声造影灌注特征与MR增强征象均表现出典型的不均匀增强性质。结论:对于高度怀疑肝内胆管癌的患者通过进行超声造影检查,可为MR增强扫描提供有力的补充,为肝内胆管癌的临床诊断及治疗提供重要的影像学依据。

Objective To compare the application value of ultrasound contrast examination and MR-enhancement scan in the diagnosis of intrahepatic cholangiocarcinoma, and analyze the characteristics of perfusion weighted imaging of them. Methods： 58 patients with suspected intrahepatic cholangiocarcinoma were enrolled in the research. All of patients underwent ultrasound contrast examination and MR enhancement scan before they received operation, and the perfusion characteristics of ultrasound contrast and sign of MR-enhanced scan for intrahepatic cholangiocarcinoma were observed. Results： In the 58 patients with suspected intrahepatic cholangiocarcinoma, 51 patients with intrahepatic cholangiocarcinoma were confirmed by using surgery and histopathology. And in the diagnoses, the sensitivity, specificity and accuracy rate of ultrasound contrast examination were 88.24%, 42.86% and 84.48%, respectively. And they were 98.04%, 57.14% and 91.38% in MR enhancement scan. And the difference between perfusion characteristics of ultrasound contrast and sign of MR-enhanced scan in arterial phase was not significant, while the differences in portal vein phase and period of delay were significant （x^2=8.99, x^2=12.732, P〈0.05）. Besides, both of the two methods showed typical non-uniform enhancement properties. Conclusion： For patients with highly suspected intrahepatic cholangiocarcinoma, ultrasound contrast examination can provide a powerful complement to MR enhanced scan, and it also can provide important iconography basis for clinical diagnosis and treatment of intrahepatic cholangiocarcinoma.