CT三维重建技术指导肝门部胆管癌手术治疗临床意义探讨  

CT three-dimensional reconstruction technology in guiding surgical resection of perihilar cholangiocarcinoma

作　　者：王鹤 宋文月 殷慧康 尤琴琴 Wang He;Song Wenyue;Yin Huikang(Department of Radiology,904th Hospital,Joint Logistics Support Force,Wuxi 214000,Jiangsu Province,China)

机构地区：[1]解放军联勤保障部队第904医院影像科,江苏省无锡市214000 [2]南京医科大学附属南京医院影像科

出　　处：《实用肝脏病杂志》2025年第2期278-281,共4页Journal of Practical Hepatology

基　　金：江苏省自然科学基金资助项目(编号:BK20201492)。

摘　　要：目的评估CT三维重建技术指导肝门部胆管癌(PHCC)手术治疗的意义。方法2019年6月~2024年6月我院收治的PHCC患者96例,均接受CT增强扫描并行三维重建Bismuth-Corlette分型。对可以行肿瘤切除的患者进行了肿瘤切除手术。结果96例PHCC患者实际接受手术72例(75.0%);CT三维重建技术评估PHCC可切除性的敏感度为97.2%,特异度为54.2%,准确度为86.5%;与实际手术切除的组织病理学检查分型比,CT三维重建Bismuth-Corlette分型的准确率为91.6%;组织病理学检查显示本组实际手术切除的PHCC患者存在侵犯肝动脉、门静脉和肝静脉以及淋巴结转移分别为25例、28例、10例和15例;CT三维重建判别侵犯肝动脉、门静脉和肝静脉以及淋巴结转移的敏感度分别为92.0%、92.0%、90.0%和86.7%,特异度分别为89.4%、90.9%、96.8%和89.5%,准确度分别为90.3%、90.3%、95.8%和88.9%。结论CT三维重建评估PHCC病灶浸润范围有助于提高术前诊断,对指导手术切除肿瘤具有很大的临床意义。Objective The aim of this study was to investigate CT three-dimensional reconstruction technology in guiding surgical resection of perihilar cholangiocarcinoma(PHCC).Methods 96 patients with PHCC were encountered in our hospital between June 2019 and June 2024,and all underwent CT scan for three-dimensional reconstruction,and tumor resection thereafter.Results Seventy-two patients(75.0%)with PHCC in our serieshad actually had their tumor resected,and the sensitivity(Se),specificity(Sp)and accuracy(Ac)of CT three-dimensional reconstruction in evaluating the resectability of PHCC were 97.2%,54.2% and 86.5%;based on histopathological classification,the Ac of CT three-dimensional reconstruction in judging Bismuth-Corlette classification was 91.6%;histopathological examination found artery,portal,venous invasion and lymph node metastasis in 25 cases,28 cases,10 cases and 15 cases out of the 72 patients with resected tumors;the Se were 92.0%,92.0%,90.0% and 86.7%,Sp were 89.4%,90.9%,96.8% and 89.5%,and Ac were 90.3%,90.3%,95.8% and 88.9% by CT three-dimensional reconstruction in judging artery,portal,venous invasion and lymph node metastasis.Conclusion Three-dimensional CT reconstruction in determining resectability of PHCC pre-operationally is helpful for clinicians making appropriate surgical decisions.

关 键 词：肝门部胆管癌 CT三维重建 Bismuth-Corlette分型 手术 

分 类 号：R73[医药卫生—肿瘤]