三期增强MDCT评价胆囊癌周围脏器受侵

目的探讨三期增强MDCT扫描对胆囊癌周围脏器受侵的诊断能力。方法收集经手术、病理证实的72例伴有周围脏器受侵的胆囊癌患者的三期增强CT扫描资料,判断周围脏器受侵的情况并评估其诊断效能。结果 72例胆囊癌CT分型分别为壁厚型29例(40.28%)、肿块型43例(59.72%);二者发生结肠和腹膜结构受侵的差异有统计学意义(P均0.05)。三期增强CT扫描诊断胆囊癌周围脏器受侵的准确率均80%,对于侵犯肝脏(52/55,94.55%)、胃窦(24/26,92.31%)和十二指肠(17/21,80.95%)的敏感度较高,而对于腹膜受侵的漏诊率较高(19/33,57.58%)。结论三期增强MDCT扫描用于诊断胆囊癌侵及周围脏器的准确率较高,但对侵及结肠、腹膜结构的敏感性仍受一定限制。

Three-phase contrast-enhanced multidetector CT in evaluation of gallbladder carcinoma with adjacent organs invaded

Objective To evaluate the ability of three-phase contrast-enhanced multidetector CT scanning to diagnose gallbladder carcinoma with adjacent organs invasion. Methods A total of 72 patients with gallbladder carcinoma confirmed by surgery or pathology were selected and underwent three phase enhanced CT scan to determine the adjacent organs invasion, and then the diagnostic efficiency were analyzed. Results Of the 72 patients with adjacent organs invasion, there were 29 cases (40.28%) with the thick wall type and 43 cases (59.72%) with the mass type. The frequencies of involvement of colon and peritoneal structure were significantly different between the mass type and the thick wall type (both P<0.05). The accuracy rates of three-phase enhanced CT scanning to differentiate the peripheral organs invaded were all above 80%, and the sensitivity were higher on liver (52/55, 94.55%), gastric antrum (24/26, 92.31%) and duodenum (17/21, 80.95%), but the missed diagnosis rates were higher on peritoneal (19/33, 57.58%). Conclusion The accuracy rate of the three-phase contrast-enhanced multidetector CT scanning in the diagnosis of gallbladder carcinoma with adjacent organs invasion is higher, but the sensitivity to the invasion of the colon and peritoneal structure is still subject to certain restrictions.