摘要
目的探讨MRI检查弥散加权成像(DWI)对肝门部胆管癌侵袭性的预测价值。方法选取我院(2016年1月至2019年1月)收治的肝门部胆管癌患者40例,均行MRI检查,观察MRI检查肝门部胆管癌情况和肝门部胆管癌临床病理因素与ADC的相关性以及治疗及随访情况。结果MRCP和MRI检查显示,肝内胆管表现为不同程度的软藤样扩张,肝门部胆管呈截断征,其中21例浸润型,4例息肉型,15例外生型。21例浸润型表现为不容程度胆管壁增厚,增强扫描显示轻、中度强化;4例息肉型T1加权成像显示低信号,T2加权成像显示高信号,增强扫描显示轻、中度强化;15例外生型T1加权成像显示低信号,T2加权成像显示稍高信号,增强扫描显示2例中度均匀强化,6例环形强化,7例轻、中度不均匀强化。所有患者MRI检查DWI显示为不同程度的弥散受限,与周围正常肝组织、胆管有明显分界。是否淋巴结转移、Ki-67指数、病理学分级、TNM分期肝门部胆管癌患者的ADC对比差异明显(P<0.05)。40例患者随访1~24个月,其中3例半年内复发,8例半年后复发,其余患者未复发或转移。结论MRI检查DWI的ADC可作为肝门部胆管癌侵袭性的影像学检查指标。
Objective To investigate the predictive value of MRI diffusion-weighted imaging(DWI)in the invasion of hilar cholangiocarcinoma.Methods 40 patients with hilar cholangiocarcinoma admitted to our hospital(from January 2016 to January 2019)were selected for MRI examination,and the correlation between ADC and the clinical and pathological factors of hilar cholangiocarcinoma as well as the treatment and follow-up were observed.Results MRCP and MRI showed that the intrahepatic bile duct showed different degrees of soft tenteroid dilatation,and the hilar bile duct showed truncation sign,among which 21 cases were invasive type,4 cases were polyp type,and 15 cases were hypoplastic type.The infiltration type in 21 cases showed incompatibility degree of bile duct wall thickening,and enhanced scan showed mild and moderate enhancement.Four polyps showed low signal on T1-weighted imaging,high signal on T2-weighted imaging,and mild and moderate enhancement on enhanced scanning.15 the abnormal biotype T1-weighted imaging showed low signal,T2-weighted imaging showed slightly high signal,and the enhanced scan showed 2 cases of moderate homogeneous enhancement,6 cases of annular enhancement,and 7 cases of mild and moderate heterogeneous enhancement.MRI DWI of all the patients showed varying degrees of diffusion limitation,which was clearly separated from the surrounding normal liver tissue and bile duct.There were significant differences in ADC between patients with lymph node metastasis,ki-67 index,pathological grading and TNM stage(P<0.05).40 patients were followed up for 1 to 24 months,among which 3 patients relapsed within 6 months,8 patients relapsed after 6 months,and the rest patients did not relapse or metastasis.Conclusion The ADC of MRI on DWI can be used as an imaging index for the invasion of hilar cholangiocarcinoma.
作者
隋录
SUI Lu(Dalian Pulandian Distract Central Hospital,Dalian 116200,China)
出处
《中国医药指南》
2020年第15期106-107,共2页
Guide of China Medicine
关键词
MRI
弥散加权成像
肝门部胆管癌
侵袭性
MRI
Diffusion weighted imaging
Hilar cholangiocarcinoma
Invasive
