壶腹周围癌MRI诊断与鉴别诊断

目的 探讨MR及MRCP成像在壶腹周围癌诊断和鉴别诊断中的价值.方法 回顾性分析经手术病理证实的54例壶腹周围癌病人的MR平扫、增强及MRCP图像,对相关结果进行χ~2检验及两独立样本t检验,并与病理结果相对照.结果 胰头癌32例,7例(21.9%)表现为"四管征";胆总管下段癌16例,9例(56.3%)表现为"三管征".2种征象在胰头癌和胆总管下段癌中差异具有显著性(P<0.05).胰头癌MRI及术中测量肿块最大面积与胆总管直径之比也明显大于胆总管下段癌(P<0.05).结论 MRI和MRCP对壶腹周围癌的诊断具有重要价值.

Diagnosis and Differential Diagnosis of MRI in Periampullary Carcinoma

Objective To explore the value of magnetic resonance cholangiopancreatography (MRCP) and MRI in the diagnosis and differential diagnosis of periampullary carcinoma. Methods Plain and dynamic multi-phase enhanced MRI data of 54 patients with periampullary carcinoma proved by pathology were retrospectively analysed. χ~2 test and two independent samples t test were used to examine the relative results. The results of MRI were compared with that of pathology. Results Of 32 cases with carcinoma of head of pancreas, 7 cases (21.9%) exhibited "four-duct sign". 16 cases were carcinomas of the lower part of common bile ducts, 9 cases (56.3%) showed "three-duct sign". The difference between carcinomas of head of pancreas and carcinomas of the lower part of common bile ducts was significant (P<0.05). Additionally, the ratio of the largest area of masses and the diameter of com-mon bile duct in pancreatic cancer tumors was larger than that in common bile duct cancer (P<0.05) for whether the intraoperative or MRI measurement. Conclusion MRI and MRCP are very helpful in diagnosis of periampullary carcinoma.