增强CT联合MRI对胆管狭窄良恶性的鉴别诊断价值

Value of Enhanced CT Combined with MRI in Differential Diagnosis of Benign and Malignant Bile Duct Stricture

目的:研究增强计算机断层扫描(CT)联合磁共振成像(MRI)对胆管狭窄良恶性的鉴别诊断价值。方法:选取2019年10月至2020年11月期间于佛山市中医院三水医院收治的82例胆管狭窄患者,分别采用CT平扫和增强CT联合MRI的方式进行检查,以病理活检作为诊断标准对检查结果进行分析,比较增强CT、MRI分别在显示狭窄胆管长度、厚度等方面的作用。结果:病理活检结果显示,恶性胆管狭窄的患者42例,良性40例;增强CT联合MRI检查的灵敏度、特异度及准确度明显高于CT平扫检查,漏诊率、误诊率明显低于CT平扫检查,差异均具有统计学意义(P<0.05);增强CT检查中,恶性胆管狭窄患者动脉期、门静脉期及延迟期的狭窄段管壁强化程度较高于良性患者,差异具有统计学意义(P<0.05);MRI扫描检查中,恶性胆管狭窄患者狭窄段壁厚、长度数值均大于良性胆管狭窄患者,管径小于良性患者,差异具有统计学意义(P<0.05)。结论:采用增强CT联合MRI对胆管狭窄患者诊断,可明确其狭窄的良恶性质。

Objective To study the value of enhanced computed tomography(CT)combined with magnetic resonance imaging(MRI)in differential diagnosis of benign and malignant bile duct stenosis.Methods A total of 82 patients with bile duct stenosis admitted to Sanshui Hospital of Foshan Hospital of Traditional Chinese Medicine from October 2019 to November 2020 were selected.Plain CT and enhanced CT combined with MRI were used for examination respectively,and pathological biopsy was used as diagnostic criteria to analyze the results.Compare the effect of enhanced CT and MRI in displaying the length and thickness of bile duct.Results Pathological biopsy results showed that 42 patients with malignant bile duct stenosis and 40 patients with benign bile duct stenosis.The sensitivity,specificity and accuracy of enhanced CT combined with MRI were significantly higher than those of the plain CT,and the rate of missed diagnosis and misdiagnosis were significantly lower than those of the plain CT,the differences were statistically significant(P<0.05).In enhanced CT examination,the degree of wall enhancement of stenosis segment in malignant bile duct stricture patients was higher than that in the benign patients in arterial phase,portal vein phase and delayed phase,and the differences were statistically significant(P<0.05).In MRI scanning,the wall thickness and length of the stenosis segment in malignant bile duct stricture patients were higher than those in the benign patients,while the diameter of the stenosis segment was smaller than that in the benign patients,the differences were statistically significant(P<0.05).Conclusion Enhanced CT combined with MRI can be used to diagnose patients with bile duct stenosis can clarify the benign and malignant nature of the stenosis.