摘要
目的:探讨多模态MRI在鉴别肝内肿块型胆管癌与不典型肝脓肿中的临床价值。方法:回顾性分析23例肝内肿块型胆管癌及23例不典型肝脓肿的MRI征象,比较两者间形态评价参数、表观扩散系数(ADC)值、增强后时间-信号强度曲线(TIC)、强化环完整性及肝胆期信号差异。结果:43%的胆管癌患者出现包膜皱缩,而23例不典型肝脓肿患者均无包膜皱缩,差异具有统计学意义(P<0.05)。肝内胆管癌与不典型肝脓肿的边缘ADCmean值分别为(0.78±0.21)×10^(-3)mm^(2)/s、(1.34±0.21)×10^(-3)mm^(2)/s,中央ADCmean值分别为(1.63±0.64)×10^(-3)mm^(2)/s、(0.82±0.23)×10^(-3)mm^(2)/s,两组间差异均有统计学意义(P<0.05)。在TIC曲线中肝内胆管癌组边缘区TIC曲线以Ⅱ型为主(18例,78%),肝脓肿组边缘区TIC曲线以Ⅰ型为主(22例,95%),两组差异有统计学意义(P<0.05)。肝内胆管癌及不典型肝脓肿中央区TIC曲线均以Ⅰ型为主,差异无统计学意义。83%的肝内胆管癌强化环不完整,87%的不典型肝脓肿强化环以完整为主,两组间差异有统计学意义(P<0.05)。肝胆期肝内胆管癌组以内高外低为主(16例,69%),不典型肝脓肿组以不均匀高信号(23例,100%),两组间差异有统计学意义(P<0.05)。结论:多模态MRI有助于鉴别肝内肿块型胆管癌与不典型肝脓肿。
Objective:To investigate the value of multiparametric magnetic resonance imaging(mpMRI)in differentiating mass-forming intrahepatic cholangiocarcinoma(MF-ICC)from atypical liver abscess.Methods:46 patients(23 with MF-ICC and 23 with atypical liver abscess)who experienced mpMRI were included in the retrospective study.Morphological features,apparent diffusion coefficient(ADC)value,time signal intensity curve(TIC),enhancement rim and signal intensity of hepatobiliary phase(HBP)were compared between two cohorts with the t test andχ^(2) test.Results:Hepatic capsular retraction showed statistically significant differences between MF-ICC(10,23;43%)and atypical liver abscess(0,23;0%)(P<0.05).The ADCmean values were(0.78±0.21)×10^(-3)mm^(2)/s and(1.63±0.64)×10^(-3)mm^(2)/s of MF-ICC at the periphery and center,respectively,and(1.34±0.21)×10^(-3)mm^(2)/s and(0.82±0.23)×10^(-3)mm^(2)/s of atypical liver abscess at the periphery and center,respectively,with significant difference(P<0.05).Eighteen(78%)MF-ICC showed typeⅡof TIC and 22(95%)atypical liver abscess showed typeⅠof TIC,with significant difference(P<0.05).83%of MF-ICC showed incomplete enhancement rim and 87%of atypical liver abscesses with complete enhancement rim,with significant difference.On HBP,MF-ICC(16,23;69%)showed central hyperintensity and peripheral hypointensity,and the liver abscess(23,23;100%)showed inhomogeneous hyperintensity,with significant difference(P<0.05).Conclusion:mpMRI may be valuable for differentiation MF-ICC from atypical liver abscess.
作者
何永红
李齐英
吴景强
陈茶金
汤琅琅
林祺
HE Yong-hong;LI Qi-ying;WU Jing-qiang(Department of Radiology,Longyan First Affiliated Hospital of Fujian Medical University,Fujian 364000,China)
出处
《放射学实践》
CSCD
北大核心
2022年第11期1391-1395,共5页
Radiologic Practice
关键词
胆管癌
肝脓肿
磁共振成像
表观扩散系数
诊断
鉴别
Cholangiocarcinoma
Atypical liver abscess
Magnetic resonance imaging
Apparent diffusion coefficient
Diagnosis
differential
