摘要
目的探讨256层螺旋CT动态容积增强扫描及三维重建在肝门部胆管癌诊治中的临床应用价值。方法选取从我院收治的肝门部胆管癌患者165例,每例患者均收集详细临床资料,根据其术前CT及三维重建结果分别进行诊断及鉴别诊断、Bismuth-corlette分型、TNM分期及可切除性判断,并以术中或术后病理诊断为金标准,统计256层螺旋CT动态容积增强扫描及三维重建在胆管癌诊断、分型、分期及可切除中的准确性。结果 165例患者的术前CT对肝门部胆管癌检出的诊断准确率为100%;256层螺旋CT对Bismuth-Corlette各个分型和术后分型结果比较差异无统计学意义(P>0.05)。T分期准确率为97.58%,N分期准确率为87.27%,M分期准确率为92.72%。165例患者的CT术前评估可切除62例,术中评估可切除54例,术前术中对比差异无统计学意义(P>0.05)。结论 256层螺旋CT动态容积增强扫描及三维重建在肝门部胆管癌诊断准确率较高。
Objective To explore the clinical application value of 256-layer spiral CT dynamic volume enhanced scanning and 3D reconstruction in the diagnosis and treatment of biliary carcinoma in the hepatic portal.Methods 165 patients with hilar cholangiocarcinoma, who were treated in our hospital from June 2011 to July 2017, were selected in this work. The clinical data of each patient were collected in detail. According to the result of the preoperative CT and three-dimensional reconstruction, the diagnosis and differential diagnosis, Bismuth-corlette parting, TNM stage and whether the removable judgement were conducted on each patient. Taking the intraoperative and postoperative pathological diagnosis as the gold standard, we performed the statistics on 256-layer spiral CT dynamic capacity enhancement scanning and three-dimensional reconstruction in diagnosis, classification, staging, and the removable accuracy of bile duct cancer.Results The diagnostic accuracy of the preoperative CT for 165 patients was 100%. There was no statistically significant difference between the 256-layer helical CT on bismuth-corlette and postoperative classification results （ P 〉0.05）. T stage accuracy was 97.58%, N staging accuracy was 87.27%, and M staging accuracy was 92.72%. In the 165 patients, 62 patients were resected before the CT surgery, 54 cases were resected in the operation, and no statistically significant difference was found in preoperative surgery （ P 〉0.05）.Conclusion 256-slice spiral CT dynamic volume scanning and 3D reconstruction have higher accuracy rate in the diagnosis and classification of hilar cholangiocarcinoma.
作者
李章柱
赵巨如
姜相森
田宁
李统
王锡明
LI Zhangzhu;ZHAO Juru;JIANG Xiangsen;TIAN Ning;LI Tong;WANG Ximing(Shandong Medical Imaging Research Institute Affiliated to Shandong University,Jinan 250021,P.R.China;Department of Radiology,Shandong Provincial Third Hospital,Jinan 250031,P.R.China;Department of Radiology,Guanxian People＇s Hospital,Guanxian 252500,P.R.China;Department of Radiology,Shandong Provincial Hospital Western Hospital,Jinan 250022,P.R.China)
出处
《医学影像学杂志》
2018年第7期1142-1146,共5页
Journal of Medical Imaging
关键词
肝门部胆管癌
三维重建
体层摄影术
X线计算机
Hepatic portal cholangiocarcinoma
3D reconstruction
Tomography
X-ray computed
