64排螺旋CT在诊断肝门性胆管癌及术前可切除性中的价值.docVIP

64排螺旋CT在诊断肝门性胆管癌及术前可切除性评估中的价值 许 美1，刘景旺2，赵 静2，郭庆乐2（2330001安徽 蚌埠，解放军第123医院影像科1，063000河北 唐山，华北煤炭医学院附属开滦医院CT室2） [摘要] 目的 探讨64排螺旋CT在肝门胆管癌及术前可切除性评估中的价值。 方法 回顾性分析2007年 10月到2009年 4月本院诊断肝门胆管癌患者的图像，患者均行64排螺旋CT扫描，利用工作站对原始数据进行图像后处理，包括多平面重组（Multi-planar reformation，MPR）及容积再现（volume rendering，VR）等技术，观察指标包括肿瘤的部位和侵及范围，肝动脉和门静脉受侵情况，是否有局部淋巴结及脏器转移；进行Bismuth-Corlette分型并将术前评估结果与手术结果进行对照分析。 结果 20例定性诊断与术后病理全部一致，定位分型准确率为85%（17/20），可根治性切除评估准确率71.4%（5/7），预测不可根治切除准确率为86.7%（13/15）。 结论 64排螺旋CT及图像后处理可作为肝门胆管癌诊断及术前评估的有效方法。 [关键词] 肝门；胆管癌；切除性；CT [中图法分类号] R816.5 [文献标志码] A The Value of 64-slice Spiral CT in the Diagnosis and Xu Mei1, Liu Jingwang2, Zhao Jing2, Guo Qingle2 （1Department of imaging the Hosptial of No.123 of PLA, Bengbu,Anhui Province,233000；2the CT room of Affiliated Kailuan Hospital of North China Coal Medical Collage, Tangshan，Hebei Province，063000，China） [Abstract] Objective To study the value of 64-slice spiral CT in the diagnosis and preoperative evaluation of hilar cholangiocarcinoma. Methods Plain and post-contrast 64-slice spiral CT findings in 20 patients with hilar cholangiocarcinoma were retrospectively analyzed. All cases underwent image reconstruction，including multi-planar reformation（MPR） and volume rendering (VR). The location, extension of tumor, infiltrated HA and PV, lymph node and liver metastatic were observed. The result of Bismuth-Corlette classification and preoperative evaluation was evaluated with operation. Results The 64-slice spiral CT had an accuracy of 100% (20/20) in diagnosis and 85% (17/20) in identifying the classification. The accuracy was 86.7%（13/15）in the un-resectability. Conclusion The 64-slice spiral CT and image reconstruction was the effective method in the diagnosis and preoperative evaluation of hilar cholangiocarcinoma. [Key words] hilar；Cholangiocarcinoma；Resectability；CT Corresponding author: Xu Mei, Tel:86-552-4973549, E-mail liujw1585@ [通信作者] 许 美,电话：（0552）4973549,E-mail liujw1585@ 肝门胆管癌是胆管癌中最常见