MRCP+DWI联合CT增强对恶性胆道梗阻性疾病的诊断价值

The Value of MRCP Combined with DWI and CT Dynamic Contrast Enhanced Scan in Diagnosis of Malignant Biliary Obstructions

目的:探讨磁共振胰胆管成像(MRCP)、扩散加权成像(DWI)联合CT增强对恶性胆道梗阻性疾病的诊断价值。方法:回顾性分析69例恶性胆道梗阻的影像表现,24例研究对象仅行MRCP+DWI检查,20例研究对象仅行CT增强检查,25例研究对象行MRCP+DWI联合CT增强检查,所有影像诊断结果与临床病理结果对照。结果:MRCP+DWI、CT增强对恶性胆道梗阻定位诊断的准确率均为100%,定性诊断准确率分别为91.67%、70.0%,差异无统计学意义(X^2=3.443,P=0.115);但两者对胆管癌的诊断准确率,差异有统计学意义(X^2=5.797,P=0.027)。MRCP+DWI联合CT增强对恶性胆道梗阻定性诊断准确率达96.0%,与MRCP+DWI比较,差异无统计学意义(X^2=0.4,P=0.609),但与CT增强比较,差异有统计学意义(X^2=5.718,P=0.034)。CT增强对病变范围、周围器官结构受累及淋巴结转移情况显示较清楚。结论:MRCP+DWI联合CT增强扫描对恶性胆道梗阻的定位定性诊断具有重要临床价值。

Objective:To investigate the value of MRCP in conjunction with DWI and CT contrast enhanced scan in locating and qualitative diagnosis of malignant biliary obstruction.Methods:The imaging features of 69 cases of malignant biliary obstruction were analyzed retrospectively.MRCP+DWI was performed in 24 patients,contrast enhanced scan in 20 patients,MRCP+DWI combined with contrast enhanced scan in 25 patients.The acquired results were compared with those of clinical pathology.Results:The accuracy of location of malignant biliary obstruction with MRCP+DWI and CT contrast enhanced scan was 100%,the accuracy of quality of malignant biliary obstruction with MRCP+DWI、CT dynamic contrast enhanced scan was 91.67%、70.0%,The difference was not statistically significant(X^2=3.443,P=0.115).However,the diagnostic accuracy of Cholangiocarcinoma was significantly different between them(X^2=5.797,P=0.027).The diagnostic accuracy of MRCP+DWI combined with CT dynamic contrast enhanced scan was 96.0%,Compared with MRCP+DWI there was no significant difference(X^2=0.4,P=0.609),but compared with CT dynamic contrast enhanced scan,the difference was significant(X^2=5.718,P=0.034).CT enhancement showed clearly the extent of the lesion,the structure of the surrounding organs and lymph node metastasis.Conclusion:MRCP+DWI combined with CT dynamic contrast enhanced scans has an important clinical value for the localization and qualitative diagnosis of malignant biliary obstruction.