【摘要】 目的探讨多排螺旋CT(MDCT)及MRI在肝门部胆管癌(HHC)术前评价中的应用价值,以期提高HHC手术切除率。方法回顾性分析26例经临床手术病理证实的HHC,分析术前MDCT及MRI改变,并与手术病理对照。结果 26例HHC中,肿块型8例,浸润型16例,管内结节乳头型2例,增强后动脉期及门静脉期表现为边缘轻中度强化,延迟期呈渐进性强化;与手术病理对照,MDCT及MRI分型符合率分别为76.9%及84.6%;MDCT正确评价胆管侵犯范围20例,MRI正确评价胆管侵犯范围22例;MDCT正确评价血管侵犯8例,MRI正确评价血管侵犯7例;淋巴结转移及肝脏侵犯13例,MDCT正确评价10例,MRI正确评价11例。结论 MDCT及MRI对HHC的分型及手术前评估具有重要价值,对于外科手术治疗具有较高的指导作用。更多还原

【Abstract】 Objective To investigate the roles of multi-detector CT(MDCT) and magnetic resonance imaging(MRI) in the preoperative evaluation of hepatic hilar cholangiocarcinoma(HHC), and to improve the surgical resection rate of this disease. Methods 26 patients with HHC confirmed by operation and pathology were retrospectively analyzed in the study. The preoperative MDCT and MRI imaging findings of these patients were analyzed and the imaging diagnosis results were compared with operative and pathological findings. Results In the 26 patients with HHC, mass type found operatively and pathologically were 8, infiltration type 16, and intraductal nodular papilla type 2. On contrast-enhanced MDCT and MRI scans arterial phase and portal venous phase, all HHC showed mild to moderate rim enhancement. In the delayed phase, the lesions demonstrated progressive enhancement. The coincidence rate of MDCT and MRI typing were 76.9% and 84.6%, respectively. The accurate detection of bile duct involvement scope was 20 patients with MDCT, and 22 patients with MRI. MDCT correctly evaluated 8 patients with vascular invasion, and MRI did 7 patients. In the 13 patients with lymph node involvements and liver metastases, MDCT and MRI diagnosed 10 and 11 patients respectively. Conclusion MDCT and MRI play a significantly important role in the typing and preoperative evaluation of HHC. The imaging findings of MDCT and MRI have a good guiding role for surgery.更多还原