MRI联合磁共振胰胆管成像鉴别诊断胆囊癌与胆囊良性肿物的临床价值  

Clinical value of MRI combined with magnetic resonance cholangiopancreatography in differential diagnosis of gallbladder cancer and benign gallbladder masses

作　　者：蓝海洋 郭希梅 刘何鹏 LAN Haiyang;GUO Ximei;LIU Hepeng(Department of Imaging,Juxian People's Hospital,Rizhao,Shandong,276500,China;Department of Hyperbaric Oxygen,Juxian People's Hospital,Rizhao,Shandong,276500,China)

机构地区：[1]莒县人民医院影像科,山东日照276500 [2]莒县人民医院高压氧科,山东日照276500

出　　处：《当代医学》2024年第10期147-150,共4页Contemporary Medicine

摘　　要：目的探讨MRI联合磁共振胰胆管成像(MRCP)在胆囊癌与胆囊良性肿物鉴别诊断中的临床价值。方法选取2020年7月至2022年7月莒县人民医院收治的98例胆囊肿瘤患者作为研究对象。所有患者均行MRI、MRCP检查,并于检查后择期手术治疗。以手术病理为金标准,分析MRI、MRCP及MRI联合MRCP鉴别诊断胆囊癌与胆囊良性肿物的价值;采用Kappa检验分析MRI、MRCP、MRI联合MRCP检查鉴别诊断胆囊癌及胆囊良性肿物与手术病理的一致性。结果MRI检出胆囊癌50例,胆囊良性肿物49例;MRCP检出胆囊癌55例,胆囊良性肿物43例;MRI联合MRCP检出胆囊癌58例,胆囊良性肿物40例。MRI联合MRCP鉴别诊断的灵敏度、准确度均高于MRI、MPCP单独检查,阴性预测值高于MRI单独检查,差异有统计学意义(P<0.05)。MRI单独检查与手术病理一致性尚可(Kappa值=0.693,P<0.001);MRCP单独检查与手术病理一致性尚可(Kappa值=0.749,P<0.001);MRI联合MRCP与手术病理一致性极好(Kappa值=0.939,P<0.001)。结论MRI结合MRCP在胆囊癌与胆囊良性肿物鉴别诊断中的临床价值较单一检查更高,能提升诊断灵敏度、准确度,减少漏诊、误诊发生,从而为临床早期治疗方案的制订提供指导。Objective To explore the clinical value of MRI combined with magnetic resonance cholangiopancreatography(MRCP)in the differential diagnosis of gallbladder cancer and benign gallbladder masses.Methods 98 patients with gallbladder tumors admitted to Juxian people's Hospital from July 2020 to July 2022 were selected as the study subjects.All patients underwent MRI and MRCP,and underwent elective surgery after the examination.The value of MRI and MRI combined with MRCP in the differential diagnosis of gallbladder cancer and benign gallbladder masses was analyzed with surgical pathology as the gold standard;Kappa test was used to analyze the consistency between MRI,MRI combined with MRCP in differential diagnosis of gallbladder cancer and benign gallbladder masses and surgical pathology.Results 59 cases of gallbladder cancer were confirmed by operation and pathology in 98 cases of gallbladder tumor,including 50 cases of gallbladder cancer and 49 cases of benign gallbladder masses detected by MRI;58 cases of gallbladder carcinoma and 40 cases of benign gallbladder masses were detected by MRI and MRCP.The sensitivity and accuracy of MRI combined with MRCP in differential diagnosis were higher than those of MRI and MPCP alone,and the negative predictive value was higher than that of MRI alone,the differences were statistically significant(P<0.05).The pathological consistency between MRI and surgery was satisfactory(Kappa=0.693,P<0.001);the pathological consistency of MRCP was satisfactory(Kappa=0.749,P<0.001).The pathological consistency of MRI combined with MRCP was excellent(Kappa=0.939,P<0.001).Conclusion The clinical value of MRI combined with MRCP in the differential diagnosis of gallbladder cancer and benign gallbladder masses is higher than that of MRI alone,which can improve the diagnostic sensitivity and accuracy,reduce the occurrence of missed diagnosis and misdiagnosis,and provide guidance for the formulation of clinical early treatment plans.

关 键 词：胆囊癌 胆囊良性肿物 磁共振胰胆管成像 鉴别诊断 临床价值 

分 类 号：R735.8[医药卫生—肿瘤]