胆囊癌多种影像学对照及外科手术切除可行性研究.pdfVIP

摘要 81.3% ；（7 ）显示肝曲结肠受侵的敏感度、特异度、总正确率、阳性预测值、 阴性预测值分别为 57.1%、66%、62.8%、48.5% 、73.3% ；（8 ）显示网膜、腹膜 受侵的敏感度、特异度、总正确率、阳性预测值、阴性预测值分别为 28.6% 、 76.0%、59.0%、40.0% 、65.5% ； （9 ）超声、CT 及磁共振对胆囊癌直接征象的 显示符合率无显著性差异；淋巴结转移检出 CT 组优于超声组；肝外胆道受侵检 出 CT 组与磁共振组效果相近；结肠肝曲受侵检出 CT 组明显优于超声组及磁共 振组。(10)根治性胆囊切除术 46 例，其中 Ι 期 8 例，Π期 23 例，Ш期 5 例，IV 期 10 例。姑息性胆囊切除术 16 例，其中 Ш 期 4 例，IV 期 12 例。剖腹探查术 16 例，其中 Ш期 2 例，IV 期 14 例。 结论 超声、CT 及 MRI 三种方法对显示胆囊癌及胆囊癌对周围结构的侵犯 具有很高价值，显示胆囊癌直接征象三者符合率不存在显著性差异；超声、CT 及 MRI 显示肝脏侵犯、肝内转移、肝内外胆道受侵的准确率较高；显示淋巴结 转移、胃十二指肠受侵、肝曲结肠受侵、网膜及腹膜受侵准确率较低，但特异度 较高；显示胆道受侵 CT 与 MRI 价值相近；显示肝曲结肠受侵 CT 明显优于超声 及 MRI ；超声、CT 及 MRI 对胆囊癌术前分期具有很高的准确率，能够对胆囊 癌进行较为全面的术前评估。 关 键 词：胆囊癌， 超声，体层摄影术，X 线计算机， 磁共振，手术切除 论文类型：应用研究 II 摘要 Subject: Comparison in multi-inconography for gallbladder cancer and surgical ablation feasibility study Specialty: Medical imaging and nuclear medicine Name: Chen Wang Supervisor: Professor Gao Wan-qin ABSTRACT Objective To explore the value of ultrasonography (US), computed tomograhpy (CT) and the magnetic resonance imaging (MRI) on the demonstration of gallbladder carcinoma and its violations of the surrounding structures ,and provide a reference for the clinic by evaluating its surgical resectability. Methods 78 cases of gallbladder carcinoma confirmed by surgery and pathology were enrolled in this study , including 23 male and 55 female aging 32-86 years old with an average age of 57.8 years. All data were collected from June, 2001 to June, 2009 in the first affiliated hospital of Henan Science and Technology University . The mainly clinical symptoms and signs are abdominal pain, jaundice, itching skin, fever, anorexia, etc. Ultrasonography in 63 cases, CT examination