DWI与THRIVE多期动态增强序列联合诊断肝外胆管癌的价值-论文.pdf

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1、临床放射学杂志2014年第33卷第2期·213·腹部放射学DWI与THRIVE多期动态增强序列联合诊断肝外胆管癌的价值曾德银，何晓鹏，赵冬梅，唐光才一【摘要】目的探讨扩散加权成像(DWI)和T。高分辨力各向同性容积激发(THRIVE)多期动态增强序列联合诊断肝外胆管癌的价值。方法病理证实29例肝外胆管细胞癌，术前MRI常规序列、DWI及THRIVE多期动态增强扫描，第1次联合MRI常规序列、THRIVE动态增强图像诊断，第2次联合所有序列图像诊断，以病理结果为金标准比较2次诊断符合率；测胆管癌、增大淋巴结的

2、表观扩散系数(ADC)值，并作均数比较t检验分析。结果手术病理证实29例肝外胆管癌，2例肝左管、2例肝右管受浸润，4例肝组织受侵，1例胆管瘤栓，淋巴结转移8枚、反应性增生l4枚。联合DWI后提高了增大淋巴结的诊断率。胆管癌、淋巴结转移、淋巴结反应性增生的ADC值(单位：10。mm／s)分别为330．50±83．58、365．75±43．52、430．79±53．77。胆管癌、淋巴结转移分别与淋巴结反应性增生比较均有统计学差异(P<0．05)，胆管癌与淋巴结转移无统计学差异(P>0．05)。结论DWI对淋巴结

3、增大敏感性高，ADC值可鉴别淋巴结转移与反应性增生；DWI与THRIVE多期动态增强联合运用诊断肝外胆管癌有较高价值。【关键词】磁共振扩散加权成像胆管癌TheValueofDWICombinedwinlTHRIVEMultiPhaseDynamicContrastEnhancedSequenceintheDiagnosisofExtrahepaticBileDuctCarcinomaZENGDeyin，HEXiaopeng，ZHAODongmei，eta1．DepartmentofRadiology，the

4、AffiliatedHospitalofLuzhouMedicalCollege，Luzhou，SichuanProvince646100，P．R．China【Abstract】ObjectiveToExploretheValueofDWIcombinedwithTHRIVEmultiphasedynamiccontrastenhancedsequenceinthediagnosisofextrahepaticbileductcarcinoma．Methods29casesofextrahepaticbil

5、eductcellcarcinomaconfirmedbypathologyunderwentMRIroutinesequence，DWIandTHRIVEmultiphasedynamiccontrastenhancedscanpriortosurgery．ThefirstdiagnosismadebyMRIroutinesequencecombinedwithTHRIVEdynamiccontrastenhancedim—ages，andtheseconddiagnosismadebycombining

6、allthesequenceimages．Thecoincidencerateofthetwodiagnosisre—suitswerecomparedaccordingtopathologicalresultsasthegoldstandard．TheADCvaluesofbileductcarcinomaandlymphnodeweremeasured．Results29casesofextrahepaticbileductcarcinomawereconfirmedbysurgeryandpathol

7、o—gy．Thelesionsincludedlefthepaticductinfiltrationin2cases，righthepaticductinfiltrationin2cases，hepatictissuein—vasionin4cases，bileducttumorthrombusin1case，lymphnodemetastasisin8andlymphnodereactivehyperplasiain14cases．Thediagnosticaccuracyofenlargedlymphn

8、odehasbeenincreasedaftercombiningwithDWI．TheADCvalue(Unit：mm／106s)ofbileductcarcinoma，lymphnodemetastasisandlymphnodereactivehyperplasiawere330．50±83．58．365．75±43．52，430．79±53．77respectively．Therewerestatisti