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目的探讨原发性胆囊癌的螺旋CT分期和手术预后评价效果。方法选择2010年2月至2013年2月间收治的经手术病理证实的45例胆囊癌患者,均进行64排螺旋CT检查,并进行相关手术与穿刺细胞学检查。结果经过观察,所有患者均表现为胆囊壁不均匀增厚,17例表现为胆囊肿块边界不清晰,21例表现为胆囊壁向腔内突出。侵犯肝脏30例,侵犯十二指肠22例,侵犯结肠5例,侵犯胆管18例。根据螺旋CT分期,Ⅰ期16例,Ⅱ期15例,Ⅲ期6例,Ⅳ8例。通过CT分期与手术结果比较发现,只有3例患者因为侵犯十二指肠只进行了细胞穿刺学检查。结论螺旋CT能清晰显示原发性胆囊癌的形态学分型与对邻近器官侵犯,为胆囊癌术前分期提供重要信息,并以此可评估其手术可切除性,对改善患者预后有重要价值。
Objective To investigate the spiral CT staging and prognosis evaluation of primary gallbladder carcinoma. Methods Forty-five patients with gallbladder carcinoma confirmed by surgery and pathology admitted from February 2010 to February 2013 were examined by 64-slice spiral CT, and related operations and biopsy were performed. Results All the patients showed uneven thickening of the gallbladder wall. The border of the gallbladder mass was not clear in 17 cases, and the gallbladder wall protruded into the cavity in 21 cases. Thirty cases of liver invasion, 22 cases of violation of the duodenum, 5 cases of violation of the colon, 18 cases of bile duct violations. According to spiral CT staging, 16 cases were stage Ⅰ, 15 cases were stage Ⅱ, 6 cases were stage Ⅲ, and 8 cases were Ⅳ. Comparisons between CT staging and surgical findings revealed that only 3 patients had a cytological examination for invasion of the duodenum. Conclusion Spiral CT can clearly show the morphological classification of primary gallbladder carcinoma and its invasion to adjacent organs, and provide important information for the preoperative staging of gallbladder carcinoma. It can evaluate the resectability of the gallbladder carcinoma and has important value in improving the prognosis of patients.