MR动态增强联合DWI对肝外胆管癌T分期的诊断价值  

Diagnostic Value of Dynamic Contrast-Enhanced MR Combined with DWI in T Staging of Extrahepatic Cholangiocarcinoma

作　　者：邢春华[1] 陈宏伟[1] 崔兴宇[1] 

机构地区：[1]南京医科大学附属无锡市人民医院医学影像科,无锡214023

出　　处：《临床放射学杂志》2015年第6期912-917,共6页Journal of Clinical Radiology

基　　金：江苏省基础研究计划(自然科学基金)-面上研究项目(编号:BK2012541)

摘　　要：目的探讨MR动态增强联合扩散加权成像（DWI）对肝外胆管癌（EHCC）T分期的诊断价值。方法回顾性分析经病理证实的39例EHCC患者术前MR动态增强和DWI扫描资料。依据病变的形态、部位、胆管浸润范围、周围血管、邻近器官或组织的侵犯情况等进行T分期,并与术后病理学分期结果进行对照。结果 39例EHCC病理分期为：T1期8例,T2期14例,T3期15例,T4期2例。MR动态增强评价T分期结果为：T1期7例,T2期17例,T3期14例,T4期1例,MR动态增强诊断准确率为84.62%（33/39）;DWI评价T分期为：T1-2期23例,T3期14例,T4期2例,诊断准确率为79.49%（31/39）;两者联合评价T分期为：T1期8例,T2期13例,T3期16例,T4期2例,总诊断准确率为94.87%（37/39）,与病理学T分期间一致性检验好（Kappa=0.924,P〈0.001）。结论 MR动态增强联合DWI扫描可以提高EHCC T分期诊断准确性。Objective To investigate the diagnostic value of dynamic contrast-enhanced scanning by magnetic resonance imaging（ MRI） combined with diffusion-weighted imaging（ DWI） in the T staging of extrahepatic cholangiocarcinoma. Methods Statistic of 39 cases pathologically confirmed extrahepatic cholangiocarcinoma were analyzed retrospectively. All cases underwent preoperative dynamic contrast-enhanced MR and DWI scan. T staging depends on the form of lesions,location,bile duct infiltration range,violations of peripheral vascular、adjacent organs or tissues. And the results were compared with pathological staging. Results Pathology revealed 39 cases including 8 cases of T1,14 cases of T2,15 cases of T3,2 cases of T4. Application of dynamic contrast-enhanced MR evaluation of T staging were as follow： 7 cases of T1,17 cases of T2,14 cases of T3,1 case of T4,the diagnostic accuracy was 84. 62%（ 33 /39）; DWI evaluation of T staging were as follow： 23 cases of T1 - 2,14 cases of T3,two cases of T4,the diagnostic accuracy was 79. 49%（ 31 /39）; The overall diagnostic accuracy of dynamic contrast-enhanced MR combing with DWI was 94. 87%（ 37 /39） ： 8 cases of T1,13 cases of T2,16 cases of T3,2 cases of T4,and the T staging consistency test with pathology was well（ Kappa =0. 924,P〈0. 001）. Conclusion Dynamic contrast-enhanced magnetic resonance imaging combined with diffusion weighted imaging have the ability to improve the T staging diagnostic accuracy in extrahepatic cholangiocarcinoma.

关 键 词：T分期 扩散加权成像 磁共振成像 动态增强 肝外胆管癌 

分 类 号：R735.8[医药卫生—肿瘤] R445.2[医药卫生—临床医学]