MRI对胆管内乳头状肿瘤侵袭性的评估价值  

Application value of MRI in invasive evaluation of intra bile duct papillary tumor

作　　者：张晓慧[1] 穆晶 袁颖[1] 赵凡 张文静 ZHANG Xiaohui;MU Jing;YUAN Ying;ZHAO Fan;ZHANG Wenjing(Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Radiology,Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of Internal Medicine,Chongqing Liangjiang New District People’s Hospital,Chongqing 401122,China)

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]承德医学院附属医院放射科,河北承德067000 [3]重庆两江新区人民医院内科,重庆401122

出　　处：《中国肿瘤外科杂志》2023年第6期556-561,共6页Chinese Journal of Surgical Oncology

摘　　要：目的分析核磁共振成像技术(MRI)在评估胆管内乳头状肿瘤侵袭性中的应用价值。方法便利抽样法选取2019年1月至2023年8月首都医科大学附属北京友谊医院、承德医学院附属医院、重庆两江新区人民医院3家三甲医院收治的100例胆管内乳头状肿瘤患者为研究对象,根据根治术后病理检查结果将患者分为侵袭组56例和非侵袭组44例,收集两组患者性别、年龄、MRI检查结果等资料,采用ROC分析MRI诊断胆管内乳头状肿瘤侵袭性的价值。结果侵袭组患者表观扩散系数(ADC)值低于非侵袭组(P<0.05),对比噪声比(除平扫期)、病灶强化率、病灶最大径均高于非侵袭组(均P<0.05),存在肝门或腹腔淋巴结肿大患者比例高于非侵袭组(均P<0.05),黏液型患者比例低于非侵袭组(均P<0.05);取ADC值、门静脉期对比噪声比、门静脉期病灶强化率绘制ROC曲线,结果显示,ADC值、门静脉期对比噪声比、门静脉期病灶强化率诊断胆管内乳头状瘤侵袭性的ROC曲线下面积(AUC)为0.813、0.797、0.753,敏感度为87.8%、85.9%、83.5%,特异度为85.7%、83.2%、81.4%;而三者联合诊断胆管内乳头状瘤侵袭性的AUC为0.864,敏感度为91.3%,特异度为86.8%。结论MRI在诊断胆管内乳头状肿瘤侵袭性中具有较高的应用价值。Objective To analyze the application value of Magnetic resonance imaging(MRI)in the invasive evaluation of intra bile duct papillary tumors.Methods A total of 100 patients with intra bile duct papillary tumors admitted to Beijing Friendship Hospital Affiliated to Capital Medical University,the Affiliated Hospital of Chengde Medical College,and Chongqing Liangjiang New District People’s Hospital from January 2019 to August 2023 were selected as the study objects by convenient sampling method.According to the pathological examination results after radical resection,the patients were divided into the invasive group(n=56)and the non-invasive group(n=44),and the data of gender,age,MRI examination results and other data of the two groups were collected.ROC was used to analyze the value of MRI in diagnosing the invasiveness of intra bile duct papillary tumors.Results The apparent diffusion coefficient(ADC)value of the invasive group was significantly lower than that of the non-invasive group(P<0.05),the contrast noise ratio(except plain scan period),the enhancement rate and the maximum diameter of the lesion were significantly higher than that of the non-invasive group(all P<0.05),and the proportion of patients with hepatic portal and abdominal lymph node enlargement was significantly higher than that of the non-invasive group(all P<0.05).The proportion of mucous-type patients was significantly lower than that of non-invasive group(P<0.05).The ROC curve was drawn by taking ADC value,portal vein phase contrast noise ratio,and portal vein phase lesion enhancement rate.The results showed that the area under the ROC curve(AUC)of ADC value,portal vein phase contrast noise ratio,and portal vein phase lesion enhancement rate for the diagnosis of intra bile duct papilloma invasion was 0.813,0.797,and 0.753.The sensitivity was 87.8%,85.9%,83.5%,and the specificity was 85.7%,83.2%,81.4%.The AUC for the combined diagnosis of intra bile papilloma was 0.864,sensitivity was 91.3%,and specificity was 86.8%.Conclusions MRI has high a

关 键 词：核磁共振成像 胆管内乳头状肿瘤 胆管肿瘤 侵袭性 评估价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.8[医药卫生—诊断学]