磁共振成像对胆管癌的诊断价值_医学论文.docVIP

磁共振成像对胆管癌的诊断价值_医学论文 磁共振成像对胆管癌的诊断价值_医学论文 作者:郝金钢，袁曙光，赵新湘，闫东，郭立 【摘要】 目的 探讨胆管癌的MRI和MRCP表现，评价MRI结合MRCP对胆管癌的诊断价值。方法 对62例经手术病理证实的胆管癌，回顾性分析其MRI和MRCP表现。结果 肝内胆管癌11例表现为肝内不规则长T1、长T2浸润性信号增强后呈中度环形强化。肝门胆管癌16例，MRI主要表现为肝内胆管扩张，在肝门部胆管突然截断、中断或充盈缺损，肝门部软组织肿块。肝外胆管癌35例，MRI表现为肝内胆管软藤样扩张，胆总管不同部位完全性梗阻。MRCP可显示扩张的肝内外胆管及梗阻部位的狭窄、中断、截断和管腔内的充盈缺损。结论 MRI和MRCP联合应用能较好地对胆管癌进行诊断，并能准确描述和评价胆管癌扩散及浸润范围。 【关键词】 胆管肿瘤；磁共振成像；胰胆管造影术，磁共振 Value of magnetic resonance imaging in dagnosing cholangiocarcinoma 【Abstract】 Objective To investigate magnetic resonance imaging（MRI） and magnetic resonance cholangiopancreatography（MRCP） features of bile duct cancer.Methods 62 cases of bile duct cancer proved surgically were analyzed retrospectively.Results The characteristic appearance of intrahepatic cholangiocarcinoma （n=11） was a large with an irregular margin.Tumor was hypointensity on T1WI and hyperintensity on T2WIand showed mild rim enhancement on enchanced MRI.The hilar cholangiocarcinoma （n=16） included intrahepatic biliary dilatationnarrowingfilling defectinterrupted or discontinued and soft tissue mass at hilum of liver.Extrahepatic cholangiocarcinoma （n=35） appeared as dilatation of intrahepatic like soft vineand the segment of common bile duct discontinued completed.Of those imaging findings the dilated intrahepatic and extrahepatic bile ductand above the obstructed common duct narrowing of MRCPfilling defectinterrupted or discontinued.Conclusion MRIwith a combination of MRCP techniquesfor the diagnostic work-up and assessmentdescribe the extension and invasion of cholangiocarcinoma. 【Key words】 bile duct neoplasmsmagnetic resonance imaging cholangiopancreatographymagnetic resonance 胆管癌在临床上并不少见，其病因至今未明，临床诊断亦较困难，多出现阻塞性黄疸后才确诊。目前，胆管癌的诊断和外科手术治疗比过去有了长足的进步［1］。随着医学影像学的发展，磁共振成像（MRI）以其无创伤、分辨率高的特性对胆管癌诊断的价值和术前评价日益受到重视。本文通过回顾性分析来探讨胆管癌在MRI的征象，以期进一步提高MRI对胆管癌的诊断。 1 资料与方法 1.1 一般资料 收集我院2005年1月～2006年2月经手术和病理证实为胆管癌的患者62例。男35例，女27例，年龄37～84岁，平均60.5岁。 1.2 方法 全部患者均行MRI扫描。使用SIEMENS Sonota 1.5T磁共振扫描仪。检查前空腹8～12h。扫描序列：平扫