MRI评价胆管内乳头状肿瘤侵袭性的价值

The Value of MRI in Evaluating the Invasiveness of Intraductal Papillary Tumors

目的探讨应用MRI评价胆管内乳头状肿瘤侵袭性的价值。方法选取2014年8月-2019年6月我院收治的胆管内乳头状肿瘤患者60例为研究对象,根据术后病理组织分为非侵袭组和侵袭组,各30例,均行腹部MRI检查,比较两组肿瘤最大直径、受累胆管扩张直径、肿瘤部位、病灶形态及血清CA199水平;通过手绘感兴趣区(ROI)测量病灶ADC值,绘制平扫期、动脉期、门静脉期、延迟期病灶的ROI,比较两组病灶强化率及对比噪声比。结果侵袭组肿瘤最大直径及血清CA199水平高于非侵袭组,ADC值低于非侵袭组,差异有统计学意义(P<0.05);两组胆管直径比较,差异无统计学意义(P>0.05);非侵袭组和侵袭组病灶位置及病灶形态比较,差异无统计学意义(P>0.05);两组动脉期、门静脉期和延迟期的对比噪声比和强化率比较,差异均有统计学意义(P<0.05)。结论肿瘤直径和血清CA199对诊断胆管内乳头状肿瘤侵袭性有重要意义,应用MRI评价胆管内乳头状肿瘤侵袭性具有较高的价值。

Objective To investigate the value of MRI in evaluating the invasiveness of intraductal papillary tumors.Methods A total of 60 patients with intraductal papillary tumor of bile duct admitted to our hospital from August 2014 to June 2019 were selected and divided into non-invasive group and invasive group according to postoperative pathological tissue,with 30 cases in each group.All patients underwent abdominal MRI examination.The maximum diameter of tumor,diameter of involved bile duct dilatation,tumor location,lesion morphology and serum CA199 level were compared between the two groups.The ADC value of the lesion was measured by hand-drawn region of interest(ROI),and the ROIs of the lesions at the plain scan stage,arterial stage,portal vein stage and delayed stage were plotted.The lesion enhancement rate and contrast noise ratio of the two groups were compared.Results The maximum tumor diameter and serum CA199 level in invasive group were higher than those in non-invasive group,ADC value was lower than that in non-invasive group,the difference was statistically significant(P<0.05);there was no significant difference in the diameter of bile duct between the two groups(P>0.05).There was no significant difference in lesion location and lesion morphology between the non-invasive group and the invasive group(P>0.05).There were statistically significant differences in the contrast noise ratio and enhancement rate between the two groups in arterial phase,portal phase and delayed phase(P<0.05).Conclusion Tumor diameter and serum CA199 are of great significance for the diagnosis of the invasiveness of intraductal papillary tumors.MRI has high value in evaluating the invasiveness of intraductal papillary tumors.