[1]张成军.常规磁共振成像联合磁共振胰胆管成像对肝门部胆管癌的诊断价值[J].新乡医学院学报,2018,35(3):235-238.[doi:10.7683/xxyxyxb.2018.03.019]
　ZHANG Cheng-jun.Value of conventional magnetic resonance imaging combined with magnetic resonance cholangiopancreatography for the diagnosis of portal cholangiocarcinoma[J].Journal of Xinxiang Medical University,2018,35(3):235-238.[doi:10.7683/xxyxyxb.2018.03.019]
点击复制

常规磁共振成像联合磁共振胰胆管成像对肝门部胆管癌的诊断价值
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年3
页码:
235-238
栏目:
临床研究
出版日期:
2018-03-05

文章信息/Info

Title:
Value of conventional magnetic resonance imaging combined with magnetic resonance cholangiopancreatography for the diagnosis of portal cholangiocarcinoma
作者:
张成军
（朝阳市中心医院放射科，辽宁　朝阳　122000）
Author(s):
ZHANG Cheng-jun
（Department of Radiology，Chaoyang Central Hospital，Chaoyang 122000，Liaoning Province，China）
关键词:
肝门部胆管癌; 磁共振成像; 磁共振胰胆管成像
Keywords:
portal cholangiocarcinoma; magnetic resonance imaging; magnetic resonance cholangiopancreatography
分类号:
R445.2
DOI:
10.7683/xxyxyxb.2018.03.019
文献标志码:
A
摘要:
目的　探讨常规磁共振成像（MRI）联合磁共振胰胆管成像（MRCP）在肝门部胆管癌（HCCA）诊断中的应用价值。方法　选择2014年9月至2016年2月朝阳市中心医院收治的HCCA患者46例为研究对象，对HCCA的常规MRI和MRCP表现进行回顾性分析。结果　46例HCCA患者中，33例可见肝门区结节，或显示不规则肿块，与相邻组织界限模糊，其中4例肝左管受累，7例肝右管受累，18例左右肝管汇合处受累，4例肝总管受累；13例未发现明显肿块。不规则肿块或肝门区结节冠状位Fiesta呈等信号，且T2加权像呈略高信号。33例肝门区结节或肿块肝脏加速容积采集序列（LAVA）扫描显示，24例动脉期强化不显著，延迟期则明显强化，表现出高信号，9例动脉期轻微强化，延迟强化不显著。13例未发现明显肿块者LAVA扫描显示，动脉期可见管壁增厚，管腔狭窄，轻微强化，延迟期强化较为显著。46例行MRCP检查显示，肝内胆管出现中度或重度扩张，呈现“软藤样”变化，33例肝门区结节或肿块可见扩张胆管在肝门位置发生断裂，其中13例呈现肝门“空虚”或“鼠尾状”狭窄。46例患者的常规MRI定位诊断准确率和定性诊断准确率分别为80.43%（37/46）、82.61%（38/46），常规MRI联合MRCP定位诊断准确率和定性诊断准确率分别为100.00%（46/46）、95.65%（44/46），MRI联合MRCP检查对HCCA的定位及定性诊断准确率显著高于单纯常规MRI检查（χ2=8.762、4.039，P<0.05）。结论　MRI联合MRCP检查对HCCA具有较高的诊断价值。
Abstract:
Objective　To investigate the value of conventional magnetic resonance imaging（MRI） combined with magnetic resonance cholangiopancreatography（MRCP） for the diagnosis of portal cholangiocarcinoma（HCCA）.Methods　Forty-six patients with HCCA in Chaoyang Central Hospital from September 2014 to February 2016 were selected as the research subjects.The characteristics of conventional MRI and MRCP of HCCA were retrospectively analyzed.Results　Among the 46 patients with HCCA，33 cases showed portal nodules or irregular lumps blurred with the adjacent tissues，13 cases showed no obvious lump.Among the 33 cases，there were 4 cases of left hepatic duct involvement，7 cases of right hepatic duct involvement，18 cases of the left and right hepatic duct confluence involvement and 4 cases of common hepatic duct involvement.The irregular lumps or portal nodules in coronal Fiesta showed equal signal and slightly higher signal in T2WI.The liver acquisition with volume acceleration（LAVA） scan of 33 cases of portal nodules or irregular lumps showed that 24 cases had no significant enhancement in arterial phase and significant enhancement in delayed phase；and 9 cases had slight enhancement in arterial phase and non significant intensification in delayed phase.The LAVA scan of the 13 cases without obvious lumps showed the thickening of the vascular wall in arterial phase，vascular stenosis，slight enhancement in arterial phase and the significant enhancement in delayed phase.The MRCP examination of 46 cases showed moderate or severe dilatation with "soft rattan like" changes in intrahepatic bile ducts.The rupture of the dilated bile duct in porta hepatis position was found in 33 cases of portal nodules or irregular lumps，and 13 cases showed "empty" or "rat tail-like" stenosis of hepatic portal.The accuracy rates of localization and qualitative diagnosis of conventional MRI in the 46 patients were 80.43%（37/46） and 82.61%（38/46），respectively；and those of conventional MRI combined with MRCP were 100.00%（46/46） and 95.65%（44/46），respectively.The accuracy rate of localization and qualitative diagnosis of HCCA by MRI combined with MRCP was significantly higher than that by conventional MRI（χ2=8.762，4.039；P<0.05）.Conclusion　MRI combined with MRCP has a high diagnostic value for HCCA.

参考文献/References:

［1］　MANSOUR J C，ALOIA T A，CRANE C H，et al.Hilar cholangiocarcinoma：expert consensus statement［J］.HPB，2015，17（8）：691-699.
［2］　喻志敏，徐鋆耀，王捷.肝门部胆管癌手术热点浅析［EB/J］.消化肿瘤杂志：电子版，2016，8（1）：10-13.DOI：10.3969/j.issn.1674-7402.2016.01.007.
［3］　卿舟，涂兵.肝门部胆管癌的诊疗现状［J］.现代医药卫生，2016，32（10）：1502-1506.
［4］　夏兴阳，邵海波，徐克.肝门部胆管癌介入术后支架再狭窄36例的原因分析及处理［J］.介入放射学杂志，2014，23（7）：597-600.
［5］　沈浮，陆建平.肝门部胆管癌的MRI诊断［J］.中华消化外科杂志，2013，12（3）：196-199.
［6］　VALLS C，RUIZ S，MARTINEZ L，et al.Radiological diagnosis and staging of hilar cholangiocarcinoma［J］.World J Gastrointest Oncol，2013，5（7）：115-126.
［7］　ENGELBRECHT M R，KATZ S S，VAN GULIK T M，et al.Imaging of perihilar cholangiocarcinoma［J］.Ajr Am J Roentgenol，2015，204（4）：782-791.
［8］　ZHANG H，ZHU J，KE F，et al.Radiological imaging for assessing the respectability of hilar cholangiocarcinoma：a systematic review and meta-analysis［J］.Biomed Res Int，2015，2015：1-11.
［9］　袁忠武.肝门部胆管癌的MRI及MRCP的诊断价值［J］.中国现代医生，2015，53（2）：110-112.
［10］　曾燕辉，帅国强.CT、MRI 技术在肝内胆管癌诊断中的联合应用价值［J］.中国当代医药，2017，24（12）：122-124.
［11］　ZHANG F，LI J，MENG Y，et al.Development of an intrabiliary MR imaging-monitored local agent delivery technique：a feasibility study in pigs［J］.Radiology，2012，262（3）：846-852.
［12］　矫娜，马捷，孙黎明，等.肝门部胆管癌MR表现与病理、肿瘤血管生成的相关性研究［J］.医学影像学杂志，2014，24（3）：465-469.
［13］　RINGE K I，RINGE B P，BEKTAS H，et al.Characterization and staging of central bile duct stenosis：evaluation of the hepatocyte specific contrast agent gadoxetate disodium［J］.Eur J Radiol，2012，81（11）：3028-3034.
［14］　朱云峰，李建生，马金良，等.三维重建技术在肝门部胆管癌术前评估中的价值［J］.中国普通外科杂志，2016，25（2）：175-180.
［15］　SOARES K C，KAMEL I，COSGROVE D P，et al.Hilar cholangiocarcinoma：diagnosis，treatment options，and management［J］.Hepatobiliary Surg Nutri，2014，3（1）：18-34.
［16］　曾焕忠，毛家骥，沈君.肝门部胆管癌合并胆管结石的影像学特征分析［J］.磁共振成像，2016，7（10）：763-768.
［17］　RUYS A T，VAN BEEM B E，ENGELBRECHT M R，et al.Radiological staging in patients with hilar cholangiocarcinoma：a systematic review and meta-analysis［J］.Br J Radiol，2012，85（1017）：1255-1262.
［18］　李明鉴，王国栋，谢海燕.螺旋CT及低场强MRI诊断肝门区胆管癌的应用价值［EB/J］.转化医学电子杂志，2015，2（8）：62-63.
［19］　XIANG S，LAU W Y，CHEN X P.Hilar cholangiocarcinoma：controversies on the extent of surgical resection aiming at cure［J］.Int J Colorectal Dis，2015，30（2）：159-171.
［20］　尹井贺.肝胆管结石合并肝胆管癌30例临床分析［J］.中国实用医药，2015，10（22）：15-16.

相似文献/References:

[1]尚伟,刘安龙,李保庆,等.口服钆喷酸葡胺溶液行磁共振泌尿系水成像的临床应用[J].新乡医学院学报,2009,26(01):059.
[2]钟凯华１,徐海斌１,白素平２. 腰椎间盘退行性变磁共振成像和病理学变化对照研究 [J].新乡医学院学报,2015,32(04):314.[doi:10.7683/xxyxyxb.2015.04.007]
[3]段芙红,白　洁,张　勇,等.颅内横纹肌样脑膜瘤的磁共振成像及病理学特征[J].新乡医学院学报,2018,35(11):991.[doi:10.7683/xxyxyxb.2018.11.011]
　DUAN Fu-hong,BAI Jie,ZHANG Yong,et al.Magnetic resonance imaging and pathological features of intracranial rhabdoid meningiomas[J].Journal of Xinxiang Medical University,2018,35(3):991.[doi:10.7683/xxyxyxb.2018.11.011]
[4]马　辉,张　燕.磁共振成像在宫颈癌分期及腹腔和盆腔淋巴结转移诊断中的价值[J].新乡医学院学报,2016,33(10):898.[doi:10.7683/xxyxyxb.2016.10.016]
　MA Hui,ZHANG Yan.Diagnostic value of magnetic resonance imaging in the staging of cervical cancer and the celiac and pelvic lymph node metastasis[J].Journal of Xinxiang Medical University,2016,33(3):898.[doi:10.7683/xxyxyxb.2016.10.016]
[5]薛生琦,王　磊,赵素亚,等.颅内血管网状细胞瘤的磁共振成像诊断及鉴别诊断[J].新乡医学院学报,2019,36(9):855.[doi:10.7683/xxyxyxb.2019.09.012]
　XUE Sheng-qi,WANG Lei,ZHAO Su-ya,et al.Magnetic resonance imaging diagnosis and differential diagnosis of intracranial angioreticuloma[J].Journal of Xinxiang Medical University,2019,36(3):855.[doi:10.7683/xxyxyxb.2019.09.012]
[6]冯中全,钱伟军,李　杰,等.磁共振成像评估大面积脑梗死慢性期患者预后的临床价值[J].新乡医学院学报,2020,37(1):052.[doi:10.7683/xxyxyxb.2020.01.013]
　FENG Zhongquan,QIAN Weijun,LI Jie,et al.Clinical value of magnetic resonance imaging in evaluating the prognosis of patients with chronic large hemispheric infarction[J].Journal of Xinxiang Medical University,2020,37(3):052.[doi:10.7683/xxyxyxb.2020.01.013]
[7]闫　冰.彩色多普勒超声与磁共振成像检查对胎儿肺隔离症的诊断价值[J].新乡医学院学报,2021,38(3):278.[doi:10.7683/xxyxyxb.2021.03.015]
　YAN Bing.Diagnostic value of color Doppler ultrasonography and magnetic resonance imaging in fetal pulmonary sequestration[J].Journal of Xinxiang Medical University,2021,38(3):278.[doi:10.7683/xxyxyxb.2021.03.015]
[8]菅　超,陈维亮.磁共振弥散张量成像及动脉自旋标记成像在缺血性脑梗死诊断及分期中的应用价值[J].新乡医学院学报,2020,37(7):648.[doi:10.7683/xxyxyxb.2020.07.0012]
　JIAN Chao,CHEN Weiliang.Application value of magnetic resonance diffusion tensor imaging and arterial spin labeling in the diagnosis and staging of cerebral ischemic infarction[J].Journal of Xinxiang Medical University,2020,37(3):648.[doi:10.7683/xxyxyxb.2020.07.0012]
[9]毛光兰,吕　方,杨荣丽,等.膝关节前交叉韧带重建术后弥散张量成像观测[J].新乡医学院学报,2020,37(12):1173.[doi:10.7683/xxyxyxb.2020.12.016]
　MAO Guanglan,LYU Fang,YANG Rongli,et al.Diffusion tensor imaging of knee joint after anterior cruciate ligament reconstruction[J].Journal of Xinxiang Medical University,2020,37(3):1173.[doi:10.7683/xxyxyxb.2020.12.016]
[10]吕　方.磁共振成像在面肌痉挛中的应用价值[J].新乡医学院学报,2018,35(5):421.[doi:10.7683/xxyxyxb.2018.05.017]
　LYU Fang.Application value of magnetic resonance imaging in hemifacial spasm[J].Journal of Xinxiang Medical University,2018,35(3):421.[doi:10.7683/xxyxyxb.2018.05.017]

更新日期/Last Update: 2018-03-05