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目的分析肝门胆管癌多层螺旋CT(MSCT)征象,评估其手术可切除性。方法回顾性地分析广东省人民医院和广东省茂名农垦医院2004年8月至2009年6月28例经临床、手术病理证实的肝门胆管癌病人的MSCT表现,评价肿瘤Bismuth-Corlette分型,评估其手术可切除性,并与手术病理结果对照分析。结果 MSCT对肿瘤定性诊断符合率为92.8%(26/28);对肿瘤分型准确率为96.4%(27/28);术前判断手术可切除13例中,实际手术可切除10例,阳性预测值为76.9%(10/13);术前判断为不可切除15例,实际不可切除14例,均行内或外引流术,阴性预测值为93.3%(14/15);MSCT预测肝门胆管癌可切除性与否的准确率为85.7%(24/28)。结论 MSCT能较准确诊断肝门胆管癌和评价病灶浸润范围,是肝门胆管癌可切除性的术前重要评价方法。
Objective To analyze the multi-slice spiral CT (MSCT) signs of hilar cholangiocarcinoma and assess its resectability. Methods The MSCT findings of patients with hilar cholangiocarcinoma confirmed by clinical and surgical pathology from August 2004 to June 2009 in Guangdong Provincial People’s Hospital and Maoming Reclamation Hospital of Guangdong Province were analyzed retrospectively to evaluate the classification of tumor Bismuth-Corlette, The surgical resectability was evaluated and compared with the surgical pathology results. Results The coincidence rate of MSCT in the qualitative diagnosis of tumors was 92.8% (26/28), and the accuracy rate of tumor classification was 96.4% (27/28). In the 13 cases resected by surgery, 10 cases were resected in the actual operation, The predictive value was 76.9% (10/13). Preoperative judgment was unresectable in 15 cases and actual unresectable in 14 cases. All cases were performed internal or external drainage. The negative predictive value was 93.3% (14/15) The accuracy of resectability of cancer was 85.7% (24/28). Conclusion MSCT can accurately diagnose hilar cholangiocarcinoma and evaluate the extent of lesion infiltration, which is an important preoperative evaluation method for resectability of hilar cholangiocarcinoma.