MRI鉴别诊断黄色肉芽肿性胆囊炎与胆囊癌的临床价值  

Clinical Value of Magnetic Resonance Imaging in Differentiating Xanthogranulomatous Cholecystitis with Gallbladder Cancer

作　　者：苟文枭 印隆林 陈晓煜[2] 谢欢[1,2] 王富民[2] 

机构地区：[1]西南医科大学医学影像系,四川泸州646000 [2]四川省医学科学院·四川省人民医院放射科,四川成都610072

出　　处：《中国普外基础与临床杂志》2016年第5期615-619,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨磁共振成像(MRI)鉴别诊断黄色肉芽肿性胆囊炎与胆囊癌的临床价值。方法回顾性分析四川省人民医院经术后病理确诊的7例黄色肉芽肿性胆囊炎患者和13例胆囊癌患者的MRI图像资料并进行对照研究。观察的主要内容包括:1胆囊壁最大厚度;2胆囊壁是弥漫性增厚或局限性增厚;3胆囊壁强化方式(均匀或不均匀);4胆囊壁"夹心饼干"样强化;5胆囊壁内结节;6胆囊壁黏膜线完整情况;7胆管有无梗阻;8胆囊或胆囊管内有无结石;9邻近肝脏是否受侵;10周围脂肪间隙是否清楚;周围淋巴结有无肿大。结果黄色肉芽肿性胆囊炎与胆囊癌的胆囊壁"夹心饼干"样强化、胆囊壁内有无结节、胆囊壁黏膜线完整情况、胆管梗阻及淋巴结肿大的影像特征比较差异有统计学意义(P<0.05),而二者的胆囊壁最大厚度、胆囊壁增厚类型、胆囊壁强化方式、有无胆囊或胆管结石、邻近肝脏浸润、周围脂肪间隙是否清楚的影像特征比较差异无统计学意义(P>0.05)。结论 MRI检查对鉴别诊断黄色肉芽肿性胆囊炎与胆囊癌具有重要价值。Objective To investigate clinical value of magnetic resonance imaging（MRI） in differentiating xanthogranulomatous cholecystitis（XGC） with gallbladder cancer（GBC）. Methods MRI data of 7 patients with XGC and 13 patients with GBC proved by surgery and pathology were analyzed retrospectively. The main contents of the observation included：（1） Maximum thickness of gallbladder wall;（2） Diffuse thickening or localized thickening of gallbladder wall;（3） Enhancement pattern（uniform or nonuniform） of gallbladder wall;（4） Gallbladder wall sandwiches enhancement;（5） Gallbladder wall nodules;（6） Completeness of gallbladder mucosa lines;（7） Obstruction of biliary tract;（8） Calculus in gallbladder or bile duct;（9） Involvement of adjacent liver;（10） Definition of surrounding fat layer; 1 1Lymphadenopathy. Results In above 11 MRI comparing features, these features such as the gallbladder wall sandwiches enhancement, the gallbladder wall nodules, the completeness of gallbladder mucosa lines, the biliary obstruction, and the lymphadenopathy were statistically significant between the XGC and the GBC（P〈0.05）, while the rest features such as the maximum thickness of gallbladder wall, the type of gallbladder wall thickening, the gallbladder wall enhancement pattern, the calculus in gallbladder or bile duct, the involvement of adjacent liver, and the definition of surrounding fat layer were not statistically significant between the XGC and the GBC（P〉0.05）. Conclusion MRI has important values in differentiating XGC with GBC.

关 键 词：黄色肉芽肿性胆囊炎 胆囊癌 磁共振成像 

分 类 号：R575.7[医药卫生—消化系统] R735.8[医药卫生—内科学] R445.2[医药卫生—临床医学]