MRI及MRCP在胆管癌中的诊断价值

目的 探讨MRI及MRCP在肝门部胆管癌的诊断价值.方法 收集2010年6月～2012年8月33例来医院就诊并经病理诊断证实了的胆管癌患者,其中男15例,女18例,年龄45-85岁,平均年龄62.3岁,所有患者均行常规MRI扫描、MRCP扫描、全部33例均行强化扫描.扫描采用GE SIGNA HDe 1.5T超导全身磁共振扫描仪.结果 浸润型13例,肿块型17例,乳头状型3例,MRI及MRCP均清楚显示,MRI表现为T1WI呈等或稍低信号,T2 WI呈等或稍高信号,增强MR扫描病灶呈延迟强化;MRCP显示扩张胆管的形态及走形的中断或狭窄.结论 MRI及MRCP均能明显的检测出肝门区胆管癌,并且在显示肿瘤的边界、胆管扩张的程度及对门静脉的侵犯有重要的临床价值,较其它影像学检查有一定的优势.它不仅提高肝门区胆管癌的诊断率,而且又为临床治疗提供证据.

The value of the combination of MRI and MRCP in the diagnosis of hilar cholangiocarcinoma

Objective To analyze and evaluate the value of the combination of MRI and MRCP in the diagnosis of hilar cholangiocarcinoma. Methods We retrospectively analyzed 33 patients with hilar cholangiocarcinoma. There were 15 males and 18 females, age ranging from 45 to 85 years old, with an average of 62.3 years old. All patients were subjected to the conventional MRI scan and MRCP and, simultaneously, all 33 cases underwent MR-LAVA. Results Of these 33 cases, 13 cases belonged to invasive type, 17 to mass type and 3 to papillary type, respectively. All loci were detected by MRI and MRCP. The tumors were shown slight hypo-intensity on T1WI and mild hyper-intensity on T2WI. After con- trast-enhanced MR, most of tumors were shown mild, limbic or inhomogeneous enhancement in artery phase and venous phase. They were characterized by lasting enhancement in delay phase. MRCP could demonstrate the bile duct tree well. The infiltrated bile ducts were usually stiff, stenotic and discontinueous. Conclusion Both MRI and MRCP are effective methods in depicting hilar cholangiocarcinoma. MRI is more valuable than other imaging method in exhibiting the tumor border, the degree of bile duct dilatation, infiltration of portal vein, and periductal spread. MR imaging will not only im- prove the diagnostic rate of hilar cholangiocarcinoma, but also offer some evidence for clinical treatment.