肝门胆管癌的磁共振诊断  

MR Imaging of Hepatic Hilar Cholangiocarcinoma

作　　者：林江[1] 陈祖望[1] 周康荣[1] 沈继章[1] 陈财忠[1] 施伟斌[1] 王炳生[2] 孙宝荣[3] 

机构地区：[1]上海医科大学附属中山医院放射科,200032 [2]上海医科大学附属中山医院普外科,200032 [3]上海医科大学附属中山医院病理科,200032

出　　处：《临床放射学杂志》2000年第2期93-96,共4页Journal of Clinical Radiology

摘　　要：目的　评价磁共振成像 (MRI)在肝门胆管癌检查中的用途 ,肝门胆管癌的MRI表现与组织病理学的关系。材料与方法搜集 2 4例经手术和病理证实的肝门胆管癌 ,分析肿瘤在MRI上的表现 ,包括肿瘤生长类型、自旋回波 (SE)T1和T2 WI上的信号特点以及动态增强规律 ,评价用MRI判断肿瘤累及范围的准确性 ,研究肿瘤的组织病理学特点。结果　MRI对肝门胆管癌的检出率达到 10 0 % ,其中浸润型 10例 ,外生型 13例 ,管内型 1例。所有肿块在T1WI上为低信号 ,多数肿块在T2 WI上为等或略高信号 ,动态增强表现为缓慢持续强化。多数肿块含有丰富的纤维间质 ,而癌细胞数量较少。MRI判断肝门胆管癌累及范围的准确性为 49%。结论　MRI扫描能准确检出和识别肝门胆管癌。多数肝门胆管癌具有典型MRI征象 ,该征象同组织病理学密切相关。但目前用MRI判断肿瘤侵犯范围尚欠准确。Objective To assess the use of MR imaging in diagnosing of hepatic hilar cholangiocarcinoma and to correlate its MR features with pathologic findings.Materials and Methods MRI was performed in 24 patients with surgically and pathologically proved hilar cholangio carcinoma. MR features, including growth type, signal intensity on spin echo and dynamic enhancement pattern of the tumor, were analyzed. The extent of the tumor involvement was assessed with MRI, and the histopathologic features were studied.Results MRI depicted all the lesions with 100% detection rate, including 10 infiltrating, 13 exophytic and 1 intraluminal lesions. All the tumors were hypointense on T 1 weighted spin echo images. Most of the tumors presented iso or mild hyper intensity on T 2 weighted images. Most tumors exhibited gradual, progressive enhancement on dynamic scanning. The majority of the lesions consisted of abundant fibrous stoma and a few tumor cells. The accuracy of MRI in assessing tumor involvement was 49%.Conclusion MRI can accurately detect and characterize hepatic hilar cholangiocarcinoma as most of them carry typical MR features, which are closely related to their pathologic characteristics. Unfortunately, up now it is still unsatisfactory for MR to determine the involvement extent of hilar cholangiocarcinoma.

关 键 词：磁共振成像 肝门胆管癌 胆管癌 诊断 

分 类 号：R735.8[医药卫生—肿瘤]