磁共振胆胰管成像对肝门部胆管癌术前分型与手术结果的对比  

Comparison of surgical results with pre-operative Bismuth types evaluated with magnetic resonance cholangiopancreatography for hilar cholangiocarcinoma

作　　者：彭耀荣[1] 万云乐[1] 李文滨[1] 伍刚[1] 李勇[2] 吴卓[2] 王捷[1] 

机构地区：[1]中山大学附属孙逸仙纪念医院肝胆外科,广州510120 [2]中山大学附属孙逸仙纪念医院放射科

出　　处：《消化肿瘤杂志（电子版）》2010年第3期158-162,共5页Journal of Digestive Oncology(Electronic Version)

摘　　要：目的 通过磁共振胆胰管成像(MRCP)对肝门部胆管癌进行术前分型,与手术探查结果对照,探讨MRCP对肝门部胆管癌术前分型的准确性及其临床价值。方法 回顾性分析在2005年1月至2010年1月在我院经手术治疗的35例肝门部胆管癌的MRCP结果,参照Bismuth分型法进行术前分型,并与手术探查结果对照。结果 MRI/MRCP术前分型包括Ⅰ型1例,Ⅱ型9例,Ⅲa型6例,Ⅲb型7例,Ⅳ型12例。手术探查结果分别为Ⅰ型1例,Ⅱ型8例,Ⅲa型5例,Ⅲb型6例,Ⅳ型15例。与手术结果对照,MRCP对肝门部胆管癌术前分型的准确性达85.7%。MRCP术前分型与手术探查无显著性差异(P>0.05)。结论 MRI/MRCP对肝门部胆管癌术前Bismuth分型的准确性较高,对决定手术方式具有重要的临床价值。如何进一步提高其准确性有待进一步研究。Objective To compare the surgical results with pre-operative Bismuth types evaluated with magnetic resonance cholangiopancreatography(MRCP) for hilar cholangiocarcinoma,and assess the accuracy of MRCP for pre-operative Bismuth typing.Methods From January 2005 to January 2010,thirty-five patients with hilar cholangiocarcinoma underwent surgical treatment in our hospital.MR/MRCP was performed pre-operatively for all the patients to evaluate Bismuth types.The accuracy of Bismuth types evaluated with pre-operative MRCP was compared with postoperative surgical results.Results Bismuth types evaluated with pre-operative MRCP included Ⅰtype in one patient,Ⅱ in 9,Ⅲa in 6,Ⅲb in 7 and Ⅳ in 12 patients.The surgical results demonstrated Ⅰtype in one patient,Ⅱ in 8,Ⅲa in 5,Ⅲb in 6 and Ⅳ in 15 patients.Compared with the surgical results,the accuracy of Bismuth types evaluated with pre-operative MRCP was 85.7%.There was no significant difference between Bismuth types evaluated with pre-operative MRCP and surgical results(P>0.05).Conclusions The accuracy of Bismuth types evaluated with pre-operative MRCP is high,which is of great clinical value for determination of surgical procedures.It should be further investigated to increase the diagnostic accuracy of MRCP for hilar cholangiocarcinoma.

关 键 词：肝门部胆管癌 MRCP 手术 BISMUTH分型 

分 类 号：R735.8[医药卫生—肿瘤]