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目的探讨联合多排螺旋CT(MSCT)、磁共振成像(MRI)术前评估肝门部胆管癌可切除性的价值。方法回顾性分析45例肝门部胆管癌患者的临床资料,分别对每例的MSCT、MRI进行独立、盲法阅片,进行术前Bismuth-Corlette分型、T分期和可切除性的判断。分别与手术资料进行比较。结果 45例患者接受根治性手术36例,姑息性手术为9例。MSCT对肝门部胆管癌的术前可切除性判断的敏感度、特异度、正确率、阳性似然比、阴性似然比分别为52.78%、44.44%、51.11%、0.95、1.06,MRI则分别为69.44%、55.56%、66.67%、1.56、0.55,两者无统计学差异(P>0.05)。联合MSCT和MRI对肝门部胆管癌的术前可切除性判断的敏感度上升为83.33%。结论联合行MSCT及MRI分析可以提高肝门部胆管癌的术前分型、T分期的准确率,为手术者提供良好的术前评估。
Objective To evaluate the value of MSCT and MRI in evaluating the resectability of hilar cholangiocarcinoma before operation. Methods The clinical data of 45 cases of hilar cholangiocarcinoma were retrospectively analyzed. The MSCT and MRI of each case were independently and blindly read, and the preoperative Bismuth-Corlette classification, T stage and resectability were evaluated. Respectively, compared with surgical data. Results 45 patients received radical surgery in 36 cases, palliative surgery in 9 cases. The sensitivity, specificity, correct rate, positive likelihood ratio and negative likelihood ratio of MSCT in judging preoperative resectability of hilar cholangiocarcinoma were 52.78%, 44.44%, 51.11%, 0.95, 1.06, respectively Respectively, 69.44%, 55.56%, 66.67%, 1.56,0.55, no significant difference between the two (P> 0.05). The sensitivity of joint MSCT and MRI in judging preoperative resectability of hilar cholangiocarcinoma increased to 83.33%. Conclusions MSCT and MRI can improve the accuracy of preoperative typing and T staging of hilar cholangiocarcinoma and provide a good preoperative evaluation for the surgeons.