摘要
目的探讨磁共振成像(magnetic resonance imaging,MRI)对肝门型胆管癌的诊断价值。方法回顾性分析21例肝门型胆管癌的动态增强MRI表现,其中9例经手术病理证实,12例经内窥镜逆行胰胆管造影术(encoscopic retrograde cholangio-pancreatography,ERCP)刷检细胞学检查证实。结果21例肝门部肿块位于肝总管8例,肝总管+左(右)肝管7例,左(右)肝管6例;平扫T1WI为低信号或等信号分别为13例(61.9%)和8例(38.1%),T2WI为高信号、稍高信号和等信号分别11例(52.4%)、7例(33.3%)、3例(14.3%),动脉期强化6例(28.6%),门脉期强化18例(85.6%),延迟期强化8例(38.1%)。远端胆管均有不同程度扩张,15例(71.4%)扩张的胆管近端呈"笔尖样"变细、僵硬,19例经MRCP发现梗阻部位。结论MRI对肝门型胆管癌的定位和定性诊断有较高价值,扩张的胆管近肿块处呈"笔尖样"变细、僵硬,有助于癌肿的鉴别诊断。
Objective To explore the value of magnetic resonance imaging（MRI） in diagnosis of cholangiocarcinoma of hepatic hilar type.Methods Dynamic enhancement MRI data of 21 cases with cholangiocarcinoma of hepatic hilar type were analyzed retrospectively,including 9 cases identified by surgery pathology and 12 cases by exfoliative cytology after endoscopic retrograde choledocho-pancreatography（ERCP）.Results In all 21 cases,8 cases of the tumors located in the common hepatic duct,7 cases in the common hepatic duct and left（or right） hepatic bile duct,6 cases in the left（or right） hepatic bile duct,13 case（61.9%） and 8 cases（38.1%） were of low signal or middle signal on T1WI respectively,11 cases（52.4%）,7 cases（33.3%）,3 cases（14.3%） were of high signal,slightly high signal and middle signal on T2WI,6 cases（28.6%） were enhanced on artery phase,18 cases（85.6%） were enhanced on portal vein,and 8 cases（38.1%） were enhanced on delay phase.And various degree of dilatation of distal bile ducts were noted,the proximal of dilatation bile duct in 15 cases（71.4%） became thin and frozen like ＂penpoint＂,the obstruction spot were found in19 cases by MRCP.Conclusion MRI is of high value on both its identification and localization of tumor in diagnosis of hepatic hilar cholangiocarcinoma.The signs of dilatation bile duct becoming thin like ＂penpoint＂ and frozen near the tumor are helpful for differential diagnosis.
出处
《同济大学学报（医学版）》
CAS
2009年第2期89-92,共4页
Journal of Tongji University(Medical Science)
关键词
胆管肿瘤
肝门型
磁共振成像
cholangiocarcinoma
hepatic hilar
magnetic resonance imaging
