磁共振胰胆管成像、肝脏三维容积快速采集动态增强扫描及扩散加权成像在诊断肝外胆管癌中的应用价值

目的 探讨磁共振胰胆管成像(MRCP)、肝脏三维容积快速采集(LAVA)动态增强扫描、扩散加权成像(DWI)在肝外胆管癌诊断中的应用价值.方法 回顾性分析84例肝外胆管病变患者的MRI影像资料,分析其影像表现,对比MRCP、LAVA动态增强扫描及DWI对肝外胆管癌的诊断效能.结果 84例患者中,病理确诊为肝外胆管癌44例,良性病变40例.MRCP 诊断为胆管癌37例,良性病变47例;LAVA动态增强扫描诊断为胆管癌45例,良性病变39例;DWI诊断为胆管癌42例,良性病变42例.MRCP、LAVA动态增强扫描、DWI诊断肝外胆管癌的敏感性分别为70.5%、93.2%、88.6%,特异性分别为85.0%、90.0%、92.5%,准确性分别为77.4%、91.7%、90.5%.结论 DWI、LAVA动态增强扫描诊断肝外胆管癌的准确性均较高,综合运用多种序列能为肝外胆管癌的诊断与分期提供更多的信息.

Application value of magnetic resonance cholangiopancreatography,three-dimension liver acceleration volume acquisition dynamic enhancement and diffusion-weighted imaging in diagnosis of extrahepatic cholangiocarcinoma

Objective To investigate the application value of magnetic resonance cholangiopancreatography(MRCP),three-dimension liver acceleration volume acquisition (LAVA) dynamic enhancement and diffusion-weighted imaging (DWI) in the diagnosis of extrahepatic cholangiocarcinoma.Methods MRI data of 84 patients with extrahepatic bile duct lesions were retrospectively analyzed.The features of imaging were also analyzed.The diagnostic efficacies of MRCP,LAVA dynamic enhancement and DWI for extrahepatic cholangiocarcinoma were compared.Results Pathological results revealed that 44 patients were diagnosed as extrahepatic cholangiocarcinoma and 40 as benign diseases among the 84 patients.Thirty-seven cases and 47 cases were diagnosed as cholangiocarcinoma and benign diseases respectively by MRCP.Forty-five cases and 39 cases were diagnosed as cholangiocarcinoma and benign diseases respectively by LAVA dynamic enhancement.Forty-two cases and 42 cases were diagnosed as cholangiocarcinoma and benign diseases respectively by DWI.For the diagnosis of the cholangiocarcinoma,the sensitivities of MRCP,LAVA dynamic enhancement and DWI were 70.5%,93.2% and 88.6% respectively,the specificities of MRCP,LAVA dynamic enhancement and DWI were 85.0%,90.0% and 92.5% respectively,and the accuracy rates of MRCP,LAVA dynamic enhancement and DWI were 77.4%,91.7% and 90.5% respectively.Conclusion DWI and LAVA dynamic enhancement obtain higher diagnostic accuracy for extrahepatic cholangiocarcinoma.The comprehensive application of multiple sequences can provide more information for the diagnosis and staging of extrahepatic cholangiocarcinoma.