3.0t磁共振成像对肝门部胆管癌的诊断价值

《3.0t磁共振成像对肝门部胆管癌的诊断价值》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、3.0T磁共振成像对肝门部胆管癌的诊断价值作者：陈建华段青薛蕴菁孙斌【摘要】目的评价3.0T磁共振成像在肝门部胆管癌疾病中的诊断价值及其优势。方法收集26例经手术和病理证实的肝门部胆管癌患者的3.0T磁共振的常规MRI、MRCP图像及B超诊断，其中12例行3D-VIBE动态增强，10例同期行CT检查，并与病理结果对比,比较它们的诊断价值。结果常规MRI结合MRCP对本组病例的定位准确率为100%，定性准确率为92.3%，超声的定位准确率92.3%，定性准确率65.4%，两者对病灶定性的准确率差异有统计学意义(P<0.05);12例3D

2、-VIBE动态增强比MR平扫多发现小病灶3例，定性诊断更加可靠;10例CT扫描2例误诊，MR检查均定性正确。结论3.0TMR平扫及MRCP对肝门部胆管癌诊断及分型具有重要价值，高于同期B超、CT诊断价值;结合3D-VIBE序列动态增强扫描则能清楚显示动脉期，门静脉期及实质期等各个时相，不但有利于小病灶的发现，还能提供病灶的血供情况，为临床提供更高价值的影像信息。【关键词】磁共振成像;肝门部胆管癌;磁共振胰胆管造影;3D-VIBE序列　　[Abstract]ObjectiveToevaluatetheclinicvalueand13advan

3、tageofmagneticresonanceimaginginthediagnosisofHilarCholangiocarcinomaat3.0TMR.MethodsTocollect26cases3.0TMRIandMRCPimagingdataandUltrasounddiagonosisofhilarcholangiocarcinomaconfirmedbyclinicalsurgeryandpathology,12ofthemhad3D-VIBEdynamiccontrast-enhancedscanning,10convent

4、ionalCTexamination,comparedwiththepathologicalresultssoastocomparetheclinicvalueofthem.ResultsTheaccuracyofplainMRscancombinedwithMRCPforevaluatingthesitesandthecauseswere100%and92.3%respectively，whereasultrasound92.3%and65.4%respectively,itisstatisticalsignificantlydiffer

5、entinqualitativeaccuracy(P<0.05).12casesof3D-VIBEdynamiccontrast-enhancedMRIfound3lesionsmorethanplainMRscan;2casesofmisdiagnosisin10casesofCTscanningbutMRexaminationswerequalitativelycorrect.Conclusion3.0TplainMRscanandMRCPisgreatclinicaldiagnosticvalueforhilarcholangi

6、ocarcinomaindiagnosisandclassification,ithashigherclinicvaluethanUltrasounddiagonosisaswellasCTexamination,whichcombinedwith3D-VIBEdynamicsequencescanclearlydemonstratethearterialphase,theportalvenousphaseandparenchymalphase,Itisnotonlyusefultofindsmalllesionswhichcannotbe

7、foundinplainscan，butalsoprovidethebloodsupplyoflesionsandhigher13valueforclinicalimaginginformation.　　[Keywords]magneticresonanceimaging;hilarcholangiocarcinomamagneticresonan-cecholangiopancreatography;three-dimensionalvolumetricinterpolatedbreath-holdexamination　　肝门部胆管癌是

8、常见的胆道肿瘤，由于其特殊的解剖位置和毗邻关系，临床诊断和治疗均有一定难度。目前外科根治性切除仍然是首选的治疗方式，但多数患者在出现临床症状就诊时已处于中晚期[1]，失去了根治性