磁共振成像对胆管癌的诊断价值.doc

1 磁共振成像对胆管癌的诊断价值作者: 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。 MRC P 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 ic resonance imaging in dagnosing 2 cholangiocarcinoma 【 Abstract 】 Objective To investigate ic resonance imaging ( MRI ) and ic resonance cholangiopancreatography ( MRCP ) features of bile duct 62 cases of bile duct cancer proved surgically were analyzed The characteristic appearance of intrahepatic cholangiocarcinoma ( n=11 ) was a large with an irregular was hypointensity on T1WI and hyperintensity on T2WI ’ and showed mild rim enhancement on enchanced hilar cholangiocarcinoma ( n=16 ) included intrahepatic biliary dilatation ’ narrowing;filling defect;interrupted or discontinued and soft tissue mass at hilum of cholangiocarcinoma ( n=35 ) appeared as dilatation of intrahepatic like soft vine;and the segment mon bile duct those imaging findings the dilated intrahepatic and extrahepatic bile duct;and above the mon duct narrowing of MRCP;filling defect;interrupted or MRI ’ with bination of MRCP techniques ’ for the diagnostic work-up and assessment ’ describe the extension and invasion of cholangiocarcinoma. 3 【 Key words 】 bile duct neoplasms;ic resonance imaging ; cholangiopancreatography ’ ic 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 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 岁。 方法全部患者均行 MRI 扫描。使用 SIEMENS Sonota 磁共振扫描仪。检查前空腹 8~ 12h 。扫描序列: 平扫横断位采