肝内胆管癌影像学诊断

影像技术的快速发展,提高了对肝内胆管癌(ICC)的准确诊断和分期,从而为临床精准治疗ICC提供依据。超声检查是ICC的一线筛查手段,简便,经济,但缺乏特异性。CT及MRI目前仍是诊断ICC的主要影像学方法。MRI具有良好的软组织分辨率和多方位成像等优势,而磁共振胰胆管成像(MRCP)技术,可进一步明确肿瘤与周围胆管关系。MRI对ICC的判别准确性总体优于CT,但CT在显示肝内胆管结石相关的ICC方面较MRI更直观。PET-CT联合CT及MRI,可提高ICC的诊断准确性,并且可弥补了CT及MRI诊断ICC区域淋巴结转移和远处转移的不足。

Imaging diagnosis of intrahepatic cholangiocarcinoma

Imaging diagnosis of intrahepatic cholangiocarcinoma GU Fang-ming,ZHOU Wei-ping. The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
Corresponding author：ZHOU Wei-ping, E-mail:ehphwp@126.com
Abstract The rapid development of imaging technology has improved the accurate diagnosis and staging of intrahepatic cholangiocarcinoma (ICC), so as to provide a basis for clinical precise treatment of ICC. Ultrasonography is the first-line screening method for ICC, which is simple and economical, but lacks specificity.CT and MRI are still the main imaging methods for the diagnosis of ICC. MRI has the advantages of good soft tissue resolution and multi-directional imaging. Magnetic resonance cholangiopancreatography (MRCP) can further define the relationship between the tumor and the surrounding bile duct. The diagnostic accuracy of MRI for ICC is better than that of CT, but CT is more direct than MRI in showing ICC associated with intrahepatic stones. PET-CT combined with CT and MRI can improve the diagnostic accuracy of ICC. PET-CT can also make up the deficiency of CT and MRI in the diagnosis of regional lymph node metastasis and distant metastasis of ICC.