胆管癌的磁共振成像表现及其临床意义

目的：通过磁共振成像(MR)征象与手术对照分析，探讨胆管癌的MR特点。方法：27例患行常规轴位SE，12加权成像和呼吸门控FSE，12加权成像，并做冠状位：MRCP成像，所有患经手术和病理证实，分析病灶信号特征、形态、范围，并与术中所见进行比较。结果：16例肝门型胆管癌在磁共振成像上多呈放射状(89％)，术中所见病灶沿胆管浸润生长，且病灶范围比MRI所见大。所有胆管癌病灶在TIWI上均呈低信号(100％)，4例肝内胆管癌在T2WI上为混杂信号，11例肝门型胆管癌在，T2WI上呈等(61％)或稍高信号(39％)，2例壶腹癌在T2WI上呈低信号。在MRCP上所有病人表现为胆道梗阻。16例(89％)：MRCP分型与临床分型一致。结论：胆管癌在磁共振成像上有较特征性表现，且能提供病变准确部位，但对病变范围估计不足，MRCP用于肝门型胆管癌临床分型是可行的。

Cholangiocarcinoma''s MR appearances and correlation with clinical results

Objective:To discuss the features of cholangiocarcinoma by comparing findings of MRI with surgery. Methods: The routine MR examination including axial SE T1WI, respiratory-triggered FSE T2WI and coronal MRCP were performed in 27 patients with cholangiocarcinoma proved surgically and pathologicaly. We compared MR appearances including lesions' signal, morphology, and extent with findings observed in surgery. Results: Hilar bile duct carcinoma appeared radiant on MRI in 16 cases(89% ) , In surgery,the lesions developing along bile duct were prominent than that seen on MRI. All masses presented low signal intensity( 100% ) on Tl WI, on T2WI,intrahepatic cholangiocarcinomas were mixd-intensity in 4 cases,hilar bile duct carcinoma showed intermediate intensity in 11 (61% ) or hyperintensity in 7(39% ) ,2 ampullary carcinoma showed lower signal. The biliary obstruction was well defined on MRCP in all cases. The classification of hilar bile duct carcinoma on MRCP was consistent with that observed in surgery in 16 cases (89% ). Conclusion ; It was concluded that the cholangiocarcinoma had characteristic appearance on MR images, and the location of masses can be determined easily, but their extent was underestimated usually. MR findings was well in accord with clinical classification. It was possible to classify the hilar bile duct carcinoma by MRCP.