多层螺旋CT与MRI在胆囊腺瘤诊断中的临床价值比较

Comparison of The Clinical Value of Multislice Spiral CT and MRI in the Diagnosis of Gallbladder Adenoma

目的探讨多层螺旋X线电子计算机断层扫描(MSCT)与磁共振成像(MRI)在胆囊腺瘤(AG)诊断中的临床价值。方法回顾性分析我院收治的48例AG患者及35例AG伴癌变患者的临床及影像资料。所有患者均经MSCT、MRI检查,观察AG和AG伴癌变的MSCT、MRI表现,评估不同影像学征象对胆囊腺瘤鉴别诊断的价值,并绘制ROC曲线。结果①MRI灵敏度、特异度、准确率、阳性阴性预测值均高于MSCT,ROC曲线显示:MRI、MSCT诊断胆囊腺瘤的AUC分为0.905、0.880;②AG伴癌变者病灶最大直径大于AG(P<0.05)。AG中病灶乳头状比例高于AG伴癌变者(P<0.05),AG病灶菜花状、表面不光滑比例低于AG伴癌变者(P<0.05);③48例AG患者均为窄基底,35例AG伴癌变患者15例为窄基底,20例为宽基底,11例患者附着胆囊处囊壁出现囊壁局限性增厚;④MSCT平扫,48例AG患者中有36例患者可清晰显示病灶,发现桑葚征32例;平扫后35例AG伴癌变均可清晰显示病灶,发现桑葚征15例;AG伴癌变者动脉期、门脉期、延迟期平均CT值均高于AG者(P<0.05);⑤MRI平扫,48例AG患者均可清晰显示病灶,发现桑葚征37例;MRI平扫,35例AG伴癌变患者均可清晰显示病灶,发现桑葚征17例。结论MSCT与MRI均可用于AG的诊断,MRI诊断效能高于MSCT。

Objective To explore the clinical value of multi-slice spiral computed tomography(MSCT)and magnetic resonance imaging(MRI)in the diagnosis of adenoma of gallbladder(AG).Methods The clinical data of 48 patients with AG and 35 patients with AG and canceration were retrospectively analyzed.All patients were examined by MSCT and MRI.The MSCT and MRI findings of AG and AG with canceration were observed.The value of different imaging findings was evaluated in the differential diagnosis of gallbladder adenoma,and the ROC curve was drawn.Results The sensitivity,specificity,accuracy rate and positive and negative predictive values of MRI were higher than those of MSCT.The ROC curve showed that the AUC values of diagnosis of adenoma of gallbladder by MRI and MSCT were 0.905 and 0.880.The maximum diameter of lesions of AG with canceration was larger than that of AG(P<0.05).The proportion of papillary lesions of AG was higher than that of AG with canceration(P<0.05),and the proportions of cauliflower-like lesions and rough surface of AG was lower than that of AG with canceration(P<0.05).48 AG patients were with narrow base,and 35 AG patients with canceration were with narrow base in 15 cases and wide base in 20 cases,and 11 patients were with localized thickening of cyst wall in the gallbladder wall.MSCT plain scan showed 36 patients could clearly show the lesions among 48 cases of AG patients and 32 cases were found with mulberry sign.After plain scan,35 AG patients with canceration could clearly show the lesions,and 15 cases were found with mulberry sign.The average CT values of arterial phase,portal phase and delayed phase of AG patients with canceration were higher than those of AG patients(P<0.05).In MRI plain scan,48 AG patients could clearly show the lesions,and 37 cases were found with mulberry sign.In MRI plain scan,35 AG patients with canceration could clearly show the lesions,and 17 cases were found with mulberry sign.Conclusion Both MSCT and MRI can be used to diagnose AG,and the diagnostic efficiency of MRI is higher than that of MSCT.