B超、CT和MRCP对原发性胆囊癌的诊断价值

目的比较B超、CT和磁共振胰胆管成像（magnetic resonance cholangiopancreatography,MRCP）检查对原发性胆囊癌的诊断价值。方法回顾性分析49例经手术及病理证实的胆囊癌患者B超、CT和MRCP资料,对其进行归纳总结。结果胆囊癌影像学直接征象可以分为厚壁型、肿块型、结节型和混合型四类,间接征象为周围组织浸润及淋巴结转移。术前B超诊断符合率为45%（18/40）,CT为60%（18/30）,MRCP为46.2%（13/23）,B超结合CT为70.8%（17/24）,B超结合MRCP为65.2%（15/23）,CT结合MRCP为63.2%（12/19）,三者联合为73.3%（11/15）。结论 B超可以对胆囊癌起到初步筛查作用,CT及MRCP诊断胆囊癌转移的价值要比B超高,联合三种检查方式对胆囊癌的诊断符合率最高。

Diagnostic value of ultrasonography,CT and MRCP for gallballder carcinoma

Objective To compare the diagnostic value of ultrasonography,CT and magnetic resonance cholangiopancreatography（MRCP） for gallbladder carcinoma.Methods Forty-nine patients with surgical and histological findings were collected in this study.Results The appearance of the primary neoplasms included four types：thick-wall type,node type,mass type and coexistent type. The indirect signs were the surrounding structures and lymphatic involvement.The coincidence rate of ultrasonography was 45%（18/40）,CT was 60%（18/30） and MRCP was 46.2%（13/23）.The coincidence rate of ultrasonography combined with CT exams was 70.8%（17/24）,ultrasonography and MRCP was 65.2%（15/23）,CT and MRCP was 63.2%（12/19）.Fifteen patients were examined by above three ways,its coincidence rate being 73.3%（11/15）.Conclusion Gallbladder carcinoma can be diagnosed initially by ultrasonography.CT and MRCP are more valuable in the detection of the spread of gallbladder carcinoma.The coincidence rate of the combined use of three techniques is the highest.