摘要
目的 :探讨MRC与PTC在肝门部恶性胆道梗阻中的临床应用价值。方法 :搜集经手术、病理或影像学证实并同时行MRC和PTC的肝门部恶性胆道梗阻患者 16例 ,其中 ,胆管癌 9例 ,转移癌 4例 (结肠癌 2例 ,胆囊癌 1例 ,胃癌 1例 ) ,肝门部肝癌 3例。分别在MRC和PTC图像上测量梗阻远端扩张的左、右肝管的宽径、狭窄段长度 ,计算并判断是否完全梗阻及其正确率。统计学处理采用配对t检验和 χ2 检验。结果 :MRC和PTC在显示扩张的左右肝管上无差异(t =1.2 7,P >0 .2及t=1.3 3 ,P >0 .2 ) ,MRC评价胆管狭窄长度和PTC相比有显著性差异 (t =3 .3 1,P <0 .0 1)。MRC判断狭窄程度的准确性明显低于PTC( χ2 =8.5 0 ,P <0 .0 0 5 )。结论 :MRC可很好的显示肝内胆管扩张程度 ,判断狭窄部位。但对狭窄程度的评估存在夸大效应。PTC不仅可评价肝内胆管扩张情况 ,并能准确测量狭窄段长度 ,判断狭窄部位是否完全梗阻。
Objective:To assess the value of magnetic resonance cholangiography (MRC) and percutaneous transhepactic cholangiography (PTC) in diagnosis of malignant biliary obstruction in hepatic hilar.Methods:Both MRC and PTC were performed in 16 cases with malignant biliary obstruction in hepatic hilar confirmed by pathology and imaging finding,among them there were nine cholangiocarcinomas,4 metastasis (2 colon cancers,1 gallbladder carcinoma,and 1 gastric cancer) and 3 hepatocellular carcinomas.The diameter of the dilated left and right hepatic bile duct and the length of narrowing were measured and the accuracy of MRC and PTC in the evaluation of extent of the narrowing was compared.Paired t test and chi square test were used.Results:There was no significant difference between MRC and PTC in measurement of the diameter of dilated biliary ducts (left: t =1.27, P >0.20 right: t =1.33, P >0.20),but there was significant difference in the evaluation of the length of narrow segments ( t =3.31, P <0.01).In the evaluation of the extent of narrowing,the accuracy of MRC was lower than PTC with great significance too (χ 2=8.50, P <0.005).Conclusion:MRC can well demonstrate the location of the obstruction and extent of dilated bile ducts,but it maybe overevaluate the narrow part. PTC can not only evaluate the extent of the dilated bile duct,but also exactly evaluate the length of narrow segment and the degree of obstruction.
出处
《放射学实践》
2003年第10期739-741,共3页
Radiologic Practice
关键词
肝门部
恶性胆道梗阻
MRC
PTC
对照研究
Hepatic hilar
Cholangiocarcinoma
Bile duct obstruction
Magnetic resonance cholangiography
