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目的探讨MR动态增强联合扩散加权成像(DWI)对肝外胆管癌(EHCC)T分期的诊断价值。方法回顾性分析经病理证实的39例EHCC患者术前MR动态增强和DWI扫描资料。依据病变的形态、部位、胆管浸润范围、周围血管、邻近器官或组织的侵犯情况等进行T分期,并与术后病理学分期结果进行对照。结果 39例EHCC病理分期为:T1期8例,T2期14例,T3期15例,T4期2例。MR动态增强评价T分期结果为:T1期7例,T2期17例,T3期14例,T4期1例,MR动态增强诊断准确率为84.62%(33/39);DWI评价T分期为:T1~2期23例,T3期14例,T4期2例,诊断准确率为79.49%(31/39);两者联合评价T分期为:T1期8例,T2期13例,T3期16例,T4期2例,总诊断准确率为94.87%(37/39),与病理学T分期间一致性检验好(Kappa=0.924,P<0.001)。结论 MR动态增强联合DWI扫描可以提高EHCC T分期诊断准确性。
Objective To investigate the diagnostic value of MR dynamic contrast-enhanced diffusion imaging (DWI) for T stage of extrahepatic cholangiocarcinoma (EHCC). Methods Thirty-nine patients with EHCC confirmed by pathology were retrospectively analyzed with MR dynamic enhancement and DWI scan data. According to the lesion morphology, location, bile duct infiltration range, peripheral blood vessels, adjacent organs or tissue violations T staging, and postoperative pathological staging results were compared. Results The pathological stages of 39 cases of EHCC were as follows: T1 in 8 cases, T2 in 14 cases, T3 in 15 cases and T4 in 2 cases. The T stage of MR dynamic enhancement was 7 cases in T1, 17 cases in T2, 14 cases in T3 and 1 case in T4, the diagnostic accuracy of MR dynamic enhancement was 84.62% (33/39). The T stage of DWI was: There were 23 cases of stage T1 ~ 2, 14 cases of stage T3 and 2 cases of stage T4, the diagnostic accuracy rate was 79.49% (31/39). The T stage was evaluated as T stage in 8 cases, T2 stage in 13 cases, T3 stage in 16 cases Cases, T4 two cases, the overall diagnostic accuracy rate was 94.87% (37/39), consistent with pathological T-test was good (Kappa = 0.924, P <0.001). Conclusions MR dynamic enhanced combined with DWI scan can improve the diagnostic accuracy of EHCC T staging.