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目的探讨磁共振成像(MRI)鉴别诊断黄色肉芽肿性胆囊炎与胆囊癌的临床价值。方法回顾性分析四川省人民医院经术后病理确诊的7例黄色肉芽肿性胆囊炎患者和13例胆囊癌患者的MRI图像资料并进行对照研究。观察的主要内容包括:1胆囊壁最大厚度;2胆囊壁是弥漫性增厚或局限性增厚;3胆囊壁强化方式(均匀或不均匀);4胆囊壁“夹心饼干”样强化;5胆囊壁内结节;6胆囊壁黏膜线完整情况;7胆管有无梗阻;8胆囊或胆囊管内有无结石;9邻近肝脏是否受侵;10周围脂肪间隙是否清楚;周围淋巴结有无肿大。结果黄色肉芽肿性胆囊炎与胆囊癌的胆囊壁“夹心饼干”样强化、胆囊壁内有无结节、胆囊壁黏膜线完整情况、胆管梗阻及淋巴结肿大的影像特征比较差异有统计学意义(P<0.05),而二者的胆囊壁最大厚度、胆囊壁增厚类型、胆囊壁强化方式、有无胆囊或胆管结石、邻近肝脏浸润、周围脂肪间隙是否清楚的影像特征比较差异无统计学意义(P>0.05)。结论 MRI检查对鉴别诊断黄色肉芽肿性胆囊炎与胆囊癌具有重要价值。
Objective To investigate the clinical value of magnetic resonance imaging (MRI) in differentiating yellow granulomatous cholecystitis from gallbladder cancer. Methods The MRI images of 7 patients with yellow granulomatous cholecystitis and 13 patients with gallbladder carcinoma diagnosed by postoperative pathology in Sichuan Provincial People’s Hospital were retrospectively analyzed and compared. The main contents of the observation include: 1 the maximum thickness of the gallbladder wall; 2 gallbladder wall is diffuse thickening or limited thickening; 3 gallbladder wall strengthening method (uniform or uneven); 4 gallbladder wall 5 gallbladder wall nodules; 6 gallbladder wall mucosal line integrity; 7 bile duct obstruction; 8 gallbladder or cystic duct stones; 9 adjacent liver is invaded; 10 around the fat gap is clear; surrounding lymph nodes with or without swelling . Results Yellow granulomatous cholecystitis and gallbladder carcinoma of the gallbladder wall “sandwich biscuit ” like enhancement, gallbladder wall nodules, complete gallbladder wall mucosal line, bile duct obstruction and lymph node enlargement of the image characteristics were statistically significant differences (P <0.05). However, there was no significant difference between the two groups in terms of the maximum thickness of the gallbladder wall, the type of gallbladder wall thickening, the gallbladder wall enhancement, gallbladder or bile duct calcification, adjacent liver infiltration, and the surrounding fat gap Statistical significance (P> 0.05). Conclusion MRI is of great value in the differential diagnosis of yellow granulomatous cholecystitis and gallbladder cancer.