CAJ | 학술논문

目的探讨多层螺旋CT(MSCT)分型在肝门胆管癌可切除性评价中的作用.方法回顾性分析经手术病理证实且术前MSCT定性诊断为肝门胆管癌的患者30例,对MSCT轴面图像及多平面重组(MPR)图像进行分析,评价肿瘤病灶的Bismuth-Codette分型及大体形态分型,并与手术病理结果进行对照分析.采用卡方检验比较不同Bismuth-Corlette分型和不同大体形态分型患者行根治性切除术的情况.结果 30例肝门胆管癌患者中,Bismuth-Corlette分型Ⅰ型、Ⅱ型、Ⅲa型、Ⅲb型和Ⅳ型分别为1、3、4、5和17例,其中17例行根治性切除术,Ⅰ型、Ⅱ型、Ⅲa型、Ⅲb型和Ⅳ型分别为1、2、1、4和9例,不同Bismuth-Corlette分型患者行根治性切除术的差异无统计学意义(X2=0.9875,P＞0.05).MSCT对Bismuth-Corlette分型的总准确率达86.7%(26/30).大体形态分型为浸润型、外生肿块型及管内结节乳头型的患者分别为13、13和4例,分别有6、8和3例行根治性切除术,不同大体形态分型患者行根治性切除术的差异无统计学意义(X2=1.2583,P＞0.05).MSCT对肿瘤大体形态分型的诊断准确率达100%(30/30).结论 MSCT能作出较为准确的Bismuth-Corlette分型及肿瘤大体形态分型诊断,为肿瘤可切除性的判断提供重要依据.
목적 탐토다층라선CT(MSCT)분형재간문담관암가절제성평개중적작용.방법 회고성분석경수술병리증실차술전MSCT정성진단위간문담관암적환자30례,대MSCT축면도상급다평면중조(MPR)도상진행분석,평개종류병조적Bismuth-Codette분형급대체형태분형,병여수술병리결과진행대조분석.채용잡방검험비교불동Bismuth-Corlette분형화불동대체형태분형환자행근치성절제술적정황.결과 30례간문담관암환자중,Bismuth-Corlette분형Ⅰ형、Ⅱ형、Ⅲa형、Ⅲb형화Ⅳ형분별위1、3、4、5화17례,기중17례행근치성절제술,Ⅰ형、Ⅱ형、Ⅲa형、Ⅲb형화Ⅳ형분별위1、2、1、4화9례,불동Bismuth-Corlette분형환자행근치성절제술적차이무통계학의의(X2=0.9875,P＞0.05).MSCT대Bismuth-Corlette분형적총준학솔체86.7%(26/30).대체형태분형위침윤형、외생종괴형급관내결절유두형적환자분별위13、13화4례,분별유6、8화3례행근치성절제술,불동대체형태분형환자행근치성절제술적차이무통계학의의(X2=1.2583,P＞0.05).MSCT대종류대체형태분형적진단준학솔체100%(30/30).결론 MSCT능작출교위준학적Bismuth-Corlette분형급종류대체형태분형진단,위종류가절제성적판단제공중요의거.
Objective To evaluate the value of multi-slice CT(MSCT)classification in the assessment of the hilar cholangiocarcinoma resectahility.Methods Thirty patients with surgically and histopathologically proved hilar cholangiocarcinomas who underwent preoperative MSCT and were diagnosed correctly were included in present study.Transverse images and reconstructed MPR images were reviewed for Bismuth-Corlette classification and morphological classification of hilar cholangiocarcinoma.Thcn MSCT classification was compared with findings of surgery and histopathology.Curative resectabilty of different types according to Bismuth-Corlette classification and morphological classification were analyzed with chi-square test.Results In 30 cases,the numbers of Type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ according to BismuthCorlette classification were 1,3,4,5 and 17.Seventeen patients underwent curative resections,among which 1,2,1,4 and 9 belonged to Type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ respectively.However,there was no significant difference in curative resectability among different types of Bismuth-Corlette classification(X2=0.9875.P＞0.05).In present study,the accuracy of MSCT in Bismuth-Corlette classification reached 86.7%(26/30).The numbers of periducatal infiltrating,mass forming and intraductal growing type were 13,13 and 4,while 6,8 and 3 cases of each type underwent curative resections.There was no significant difference in curative resectability among different types of morphological classification(X2=1.2583,P＞0.05).The accuracy of MSCT in morphological classification was 100%(30/30)in this study group.Conclusion MSCT can make accurate diagnosis of Bismuth-Corlette classification and morphological classification.which is helpful in preoperative respectability assessment of hilar cholangiocarcinoma.