多模态超声联合磁共振对早期胆囊癌的鉴别诊断价值

Value of multimodal ultrasound combined with magnetic resonance imaging in differential diagnosis of early gallbladder carcinoma

目的探讨多模态超声联合磁共振对早期胆囊癌的鉴别诊断价值。方法选取2018年6月至2019年12月许昌市人民医院收治的86例疑似早期胆囊癌患者作为研究对象,所有患者均接受多模态超声及磁共振检查,且在接受检查后2周内接受手术治疗,以手术病理检查结果为"金标准",分析单一多模态超声、磁共振单独及联合鉴别诊断早期胆囊癌的价值。结果经手术病理检查,86例疑似胆囊癌患者检出早期胆囊癌35例(鳞状细胞癌7例,腺癌25例,未分化癌3例),检出胆囊炎51例。多模态超声、磁共振单独与联合诊断的特异度分别为64.71%(33/51)、68.43%(35/51)、80.39%(41/51),阳性预测值分别为55.00%(22/40)、60.98%(25/41)、76.19%(32/42),阴性预测值分别为45.00%(18/40)、39.02%(16/41)、23.81%(10/42),3种检查方式比较差异未见统计学意义(P>0.05)。多模态超声、磁共振联合诊断准确度(84.88%,73/86)及灵敏度(91.43%,32/35)高于单独使用多模态超声[63.95%(55/86)、62.86%(22/35)]、磁共振检查[69.77%(60/86)、71.43%(25/35)],差异有统计学意义(P<0.05)。结论多模态超声与磁共振联合诊断具有协同作用,对早期胆囊癌有较高的鉴别诊断价值。

Objective To investigate the value of multimodal ultrasound combined with magnetic resonance imaging in the differential diagnosis of early gallbladder cancer.Methods A total of 86 patients with suspected early gallbladder cancer admitted to Xuchang People’s Hospital from June 2018 to December 2019 were selected as the research objects.All patients underwent multimodal ultrasound and magnetic resonance examination,and received surgical treatment within 2 weeks after examination.The results of surgical pathology were taken as the"gold standard",while the value of single multimodal ultrasound,single magnetic resonance imaging,and combination of them in the differential diagnosis of early gallbladder cance were analyzed.Results In the 86 patients with suspected gallbladder cancer,35 cases were diagnosed with early gallbladder cancer(7 cases squamous cell carcinoma,25 cases adenocarcinoma,3 cases undifferentiated carcinoma),and 51 cases were diagnosed with cholecystitis.The specificity of multimodal ultrasound,magnetic resonance imaging alone,and combination of them were 64.71%(33/51),68.43%(35/51)and 80.39%(41/51),respectively;the positive predictive values of the three methods were 55.00%(22/40),60.98%(25/41)and 76.19%(32/42),respectively;the negative predictive values were 45.00%(18/40),39.02%(16/41)and 23.81%(10/42),respectively.There was no significant difference in the three kinds of indexes among the three methods(P>0.05).The accuracy and sensitivity of combination of multimodal ultrasound with magnetic resonance imaging were 84.88%(73/86)and 91.43%(32/35),respectively,higher than the 63.95%(55/86)and 62.86%(22/35)of multimodal ultrasound,and the 69.77%(60/86)and 71.43%(25/35)of magnetic resonance imaging,and the difference was statistically significant(P<0.05).Conclusions The combination of multimodal ultrasound with magnetic resonance imaging has a synergistic effect,which has a high value in the differential diagnosis of early gallbladder cancer.