摘要
目的探讨肝脏T1、T2期末梢型胆管细胞癌（PCC）的MRI特征及其鉴别诊断。方法选取资料完整并经手术病理证实的T1、T2期末梢型胆管细胞癌26例患者为研究对象，并随机抽取直径小于3cm的肝脏孤立性乏血供转移瘤（HM）23例、肝脏孤立性坏死结节（SNN）29例作对照组。分析各组患者的MRI特征，采用妒检验或Fisher确切概率法对两组肿瘤的MRI表现进行统计学分析，并对2名医师的读片结果进行接受者操作特性（ROC）曲线分析。结果肝脏T1、T2期末梢型胆管细胞癌呈直径小于3cm的结节灶，10例≤2．0cm，16例在2．0～3．0cm之间，病灶边界清楚（n=22，85％）、T2W1上瘤体呈均匀稍高信号（n=23，88％），增强后病灶呈斑片状强化（n=20，77％）及对比剂向心性扩散（n=21，81％），中心与周边出现弱强化带（n=9，35％）等征象的发生率较非胆管细胞癌组高，以上因素两组差异有统计学意义（P〈0．05）。2名医师阅片的ROC曲线下面积Az为0．896±0．037，敏感度为84．6％，特异性为86．5％。结论肝脏T1、T2期末梢型胆管细胞癌MRI表现具有一定特征，结合临床病史及实验室检查，多数情况下可作出较准确的术前诊断。
Objective To study the MR imaging appearances in a series of patients with stages T1N0M0 and T2N0M0 peripheral cholangiocarcinoma of the liver and to differentiate these tumors from hepatic metastases and from other solitary necrotic nodules. Methods A retrospective analysis was carried out on MR examinations of 26 patients with histologically confirmed choangiocareinoma. The imaging findings were compared with those of 2 non-choangiocarcinoma groups including 23 patients with metastasis and 29 patients with solitary necrotic nodules confirmed with surgery, biopsy or follow-up imagings. Statistical analy- sis included Chi-square test or Fisher＇s exact test and the use of receiver operating characteristic （ROC） curves. Results Peripheral choangiocarcinomas in stages T1N0M0 and T2N0M0 were less than or equal to 3 cm in diameter （10 patients, ≤2 cm and 16 patients, 2 cm）. Common findings for cholangiocarcinoma were defined margins （n =22, 85% ）, slightly high signal on T2W1 （n =23, 88% ）, patchy enhancement （n = 20, 77% ）, ＂fill-in＂ enhancement from periphery toward the center （n = 21, 81% ） and diffuse hypointensity at the periphery and center of tumor （n = 9, 35%）. There were significant differences （ P 〈 0. 05 ） between the choangiocarcinoma group and the non-cholangiocarcinoma group in the above imaging findings. The area under the curve （Az） for differentiating peripheral cholangiocareinoma was 0. 896 ± 0. 037, sensitivity was 84. 6%, and specificity was 86. 5%. Conclusions Our data indicated that MRI features of peripheral cholangioearcinoma in stages T1N0M0 and T2N0M0 could be determined. MR imaging, when combined with clinical and biochemical data, provided reliable information to diagnose peripheral cholangioearcinoma.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2014年第6期435-439,共5页
Chinese Journal of Hepatobiliary Surgery
关键词
肝脏肿瘤
胆管细胞癌
磁共振成像
Liver neoplasms
Cholangiocareinoma
Magnetic resonance imaging
