肝内胆管细胞癌神经周围侵犯的术前CT预测  

Preoperative CT prediction of perineural nerve invasion in intrahepatic cholangiocarcinoma

作　　者：王立学 白博锋 李洁[1] 张晨[1] 乔健 乔欣荣 郑卓肇[1] WANG Lixue;BAI Bof eng;LI Jie;ZHANG Chen;QIAO Jian;QIAO Xinrong;ZHENG Zhuozhao(Departmentof Radiology,Beijing Tsinghua Changgung Hospital,Schoolof Clinical Medicine,Tsinghua University,Beijing 102218,China;Departmentof MedicalImaging,Xi’an First Hospital,Xi’an 710002,China)

机构地区：[1]清华大学附属北京清华长庚医院放射科,北京102218 [2]西安市第一医院医学影像科,陕西西安710002

出　　处：《实用放射学杂志》2022年第5期764-767,785,共5页Journal of Practical Radiology

基　　金：北京清华长庚医院研究基金资助项目(12021C1017).

摘　　要：目的探讨术前CT预测肝内胆管细胞癌(ICC)神经周围侵犯(PNI)的可行性。方法回顾性分析经手术病理证实的ICC患者41例,其中22例(53.66%)存在PNI。在术前上腹部CT增强成像分析是否伴有胆管扩张、动脉期强化模式、腹腔丛脂肪密度变化等12种CT征象,采用Mann-Whitney U检验或χ2检验对比PNI组和非PNI组间的差异,应用Logistics回归分析CT征象与PNI的相关性。结果术前CT征象中,PNI组的胆管扩张(77.27%vs 36.84%,P=0.009)和动脉期低强化模式(54.55%vs 21.05%,P=0.028)的发生率显著高于非PNI组。多因素Logistics回归分析显示,胆管扩张征象与PNI独立相关[优势比(OR)5.764,95%置信区间(CI)1.162~28.599,P=0.032]。结论术前CT预测ICC PNI具有可行性,CT显示的伴有胆管扩张为独立危险因素。Objective To investigate the feasibility of preoperative CT in predicting peripheral nerve invasion(PNI)of intrahepatic cholangiocarcinoma(ICC).Methods A total of 41 cases of ICC confirmed by operation and pathology were analyzed retrospectively,22 cases(53.66%)of which had PNI.Twelve CT signs such as bile duct dilatation,arterial phase enhancement mode and the change of fat density of celiac plexus on preoperative enhanced CT images of upper abdomen were assessment.Mami-Whitney U test or X2 test was used to compare the differences between PNI group and non-PNI group.Logistics regression was used to aneilyze the correlations between CT signvs and PNI.Results Among the preoperative CT signs,the incidences of bile duct dilatation(77.27%vs 36.84%,P=0.009)and arterial phase low enhancement mode(54.55%vs 21.05%,P=0.028)in the PNI group were significantly higher than those in the non-PNI group.Multivariate Logistics regrevSvsion analysis showed that the sign of bile duct dilatation was independently related to PNI[odds ratio(OR)5.764,95%confidence interval(CI)1.162-28.599,P=0.032].Conclusion Preoperative CT is feasible to predict PNI in ICC,and the bile duct dilatation is an independent risk factor.

关 键 词：肝内胆管细胞癌 神经周围侵犯 计算机体层成像 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]