CT检查对诊断胆囊腺肌症的效能分析

Multi-slice spiral CT features of patients with gallbladder adenomyosis different from with gallbladder cancer

目的总结胆囊腺肌症与胆囊癌患者多层螺旋CT(MSCT)表现特征。方法2015年9月~2020年9月我院诊治的胆囊腺肌症患者113例和胆囊癌患者78例,均接受MSCT和超声检查,外科手术治疗后行组织病理学检查。结果MSCT检查结果与术后组织病理学检查结果的一致性(Kappa=0.749)显著高于超声检查(Kappa=0.577);MSCT诊断胆囊腺肌症的准确度为88.0%,显著高于超声检查的79.6%(P<0.05);MSCT对局限型胆囊腺肌症的检出率为97.1%,显著高于超声检查的82.9%(P<0.05);在CT检查上,胆囊腺肌症表现为胆囊壁光滑、RAS窦和肝胆交界清楚显示率分别为36.3%、36.3%和69.0%,显著高于胆囊癌组的9.0%、6.4%和38.5%(P<0.05)。结论MSCT检查诊断胆囊腺肌症有较高的正确率,其特征有助于与胆囊癌鉴别。

Objective The aim of this study was to summarize the imaging features of multi-slice spiral CT(MSCT)in patients with gallbladder adenomyosis and in patients with gallbladder carcinoma.Methods 113 patients with gallbladder adenomyosis and 78 with gallbladder carcinoma were enrolled in our hospital between September 2015 and September 2020,and all patients underwent MSCT and ultrasonography.The histophthological examination was performed after surgery.Results The consistency of diagnosis by MSCT based on postoperative histopathological examination(Kappa=0.749)was stronger than that by ultrasonography(Kappa=0.577);the accuracy rate by MSCT scan in the diagnosis of patients with gallbladder adenomyosis was higher than that by ultrasonography(88.0%vs.79.6%,P<0.05);the diagnosis of special,local gallbladder adenomyosis,by MSCT was also higher than that by ultrasonography(97.1%vs.82.9%,P<0.05);the CT scan showed that the percentages of smooth gallbladder walls,RAS sinus display and clear boundary between liver and gallbladder in patients with gallbladder adenomyosis were 36.3%,36.3%and 69.0%,all significantly higher than 9.0%,6.4%and 38.5%in patients with gallbladder carcinoma(P<0.05).Conclusion The diagnostic accuracy of patients with gallbladder adenomyosis by MSCT is relatively high,and its imaging feature might help discriminate gallbladder adenomyosis from cancer.