3.0T磁振成像对肝门部胆管癌的诊断价值.docVIP

3.0T磁共振成像对肝门部胆管癌的诊断价值 【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(P0.05);12例3D-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 3.0T MR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 Diagnostic Value of Magnetic Resonance Imaging for the Hilar Cholangiocarcinoma at 3.0T MRI 　　CHEN Jian-hua ,DUAN Qing, XUE Yun-jing, et al. Department of medical imaging，Union Hospital，Fujian Medical University，Fuzhou 350001，China 　　[Abstract] Objective To evaluate the clinic value and advantage of magnetic resonance imaging in the diagnosis of Hilar Cholangiocarcinoma at 3.0T MR. Methods To collect 26 cases 3.0T MRI and MRCP imaging data and Ultrasound diagonosis of hilar cholangiocarcinoma confirmed by clinical surgery and pathology, 12 of them had 3D-VIBE dynamic contrast-enhanced scanning, 10 conventional CT examination, compared with the pathological results so as to compare the clinic value of them. Results The accuracy of plain MR scan combined with MRCP for evaluating the sites and the causes were 100% and 92.3% respectively，whereas ultrasound 92.3% and 65.4% respectively, it is statistical significantly different in qualitative accuracy(P0.05). 12 cases of 3D-VIBE dynamic contrast-enhanced MRI found 3 lesions more than plain MR scan; 2 cases of misdiagnosis in 10 cases of CT scanning but MR examinations were qualitatively correct. Conclusion 3.0T plain MR scan and MRCP is great clinical diagnostic value for hilar cholangiocarcinoma in diagnosis and classification,it has higher clinic value than Ultrasound diagonosis as well as CT examination, which combined with 3D-VIBE dynamic sequences can clearly demonstrate the arterial phase, the portal venous phase and parenchyma