论文部分内容阅读
目的:探讨LAVA动态增强磁共振成像(MRI)对肝外胆管癌诊断的准确性和临床意义。方法:回顾性分析28例临床怀疑肝外胆管癌患者的LAVA动态增强MRI资料。所有病例均行1.5 T磁共振T1加权成像(T1WI)、T2加权成像(T2WI)、扩散加权成像(DWI)及阵列空间敏感编码技术(ASSET)、LAVA动态增强磁共振成像(LAVA-DCE MRI)。结果:28例患者均经病理证实,肝门区胆管13例,胆总管上段3例,中段5例,胆总管下段4例,壶腹部3例。平扫:病灶T1WI呈低信号、稍低信号或等信号,T2WI呈高信号、稍高信号和等信号,DWI呈稍高信号或高信号。LAVA动态增强:动脉期肿块轻度强化5例,门脉期肿块轻-中度强化16例,延迟期肿块延迟强化7例。本组病例中分别有3例肝门区胆管癌误诊为肝细胞型肝癌,2例胆总管下段癌误诊为胆管炎,诊断准确率为82.1%。结论:LAVA动态增强MRI对肝外胆管癌的诊断具有重要价值。
Objective: To investigate the accuracy and clinical significance of LAVA dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnosis of extrahepatic cholangiocarcinoma. Methods: A retrospective analysis of 28 cases of clinically suspected extrahepatic cholangiocarcinoma patients with LAVA dynamic enhanced MRI data. All patients underwent 1.5 T magnetic resonance T1 weighted imaging (T1WI), T2 weighted imaging (T2WI), diffusion weighted imaging (DWI) and array space sensitive coding (ASSET), LAVA-DCE MRI . Results: Twenty-eight patients were pathologically confirmed. There were 13 cases of hilar bile duct, 3 cases of upper common bile duct, 5 middle bile duct, 4 lower bile duct and 3 cases of ampulla. Plain scan: lesion T1WI showed low signal, slightly lower signal or equal signal, T2WI showed high signal, slightly higher signal and equal signal, DWI slightly higher signal or high signal. Dynamic enhancement of LAVA: mild enhancement of arterial phase in 5 cases, moderate to moderate enhancement in 16 cases of portal vein, delayed enhancement of delayed mass in 7 cases. In this group, 3 cases of hilar cholangiocarcinoma were misdiagnosed as hepatocellular carcinoma, and 2 cases of choledocholithiasis were misdiagnosed as cholangitis. The diagnostic accuracy was 82.1%. Conclusion: LAVA dynamic enhanced MRI is of great value in the diagnosis of extrahepatic cholangiocarcinoma.