中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
9期
1610-1614
,共5页
陈希奎%唐贵超%邢小明%兰莲君
陳希奎%唐貴超%邢小明%蘭蓮君
진희규%당귀초%형소명%란련군
体层摄影术,X线计算机%磁共振成像%肝门部胆管癌
體層攝影術,X線計算機%磁共振成像%肝門部膽管癌
체층섭영술,X선계산궤%자공진성상%간문부담관암
Tomography,X-ray computed%Magnetic resonance imaging%Hepatic hilar cholangiocarcinoma
目的：探讨多排螺旋CT（MDCT）及MRI在肝门部胆管癌（HHC）术前评价中的应用价值，以期提高HHC手术切除率。方法回顾性分析26例经临床手术病理证实的HHC，分析术前MDCT及MRI改变，并与手术病理对照。结果26例HHC中，肿块型8例，浸润型16例，管内结节乳头型2例，增强后动脉期及门静脉期表现为边缘轻中度强化，延迟期呈渐进性强化；与手术病理对照，MDCT及MRI分型符合率分别为76.9%及84.6%；MDCT正确评价胆管侵犯范围20例， MRI正确评价胆管侵犯范围22例；MDCT正确评价血管侵犯8例，MRI正确评价血管侵犯7例；淋巴结转移及肝脏侵犯13例，MDCT正确评价10例，MRI正确评价11例。结论 MDCT及MRI对HHC的分型及手术前评估具有重要价值，对于外科手术治疗具有较高的指导作用。
目的：探討多排螺鏇CT（MDCT）及MRI在肝門部膽管癌（HHC）術前評價中的應用價值，以期提高HHC手術切除率。方法迴顧性分析26例經臨床手術病理證實的HHC，分析術前MDCT及MRI改變，併與手術病理對照。結果26例HHC中，腫塊型8例，浸潤型16例，管內結節乳頭型2例，增彊後動脈期及門靜脈期錶現為邊緣輕中度彊化，延遲期呈漸進性彊化；與手術病理對照，MDCT及MRI分型符閤率分彆為76.9%及84.6%；MDCT正確評價膽管侵犯範圍20例， MRI正確評價膽管侵犯範圍22例；MDCT正確評價血管侵犯8例，MRI正確評價血管侵犯7例；淋巴結轉移及肝髒侵犯13例，MDCT正確評價10例，MRI正確評價11例。結論 MDCT及MRI對HHC的分型及手術前評估具有重要價值，對于外科手術治療具有較高的指導作用。
목적：탐토다배라선CT（MDCT）급MRI재간문부담관암（HHC）술전평개중적응용개치，이기제고HHC수술절제솔。방법회고성분석26례경림상수술병리증실적HHC，분석술전MDCT급MRI개변，병여수술병리대조。결과26례HHC중，종괴형8례，침윤형16례，관내결절유두형2례，증강후동맥기급문정맥기표현위변연경중도강화，연지기정점진성강화；여수술병리대조，MDCT급MRI분형부합솔분별위76.9%급84.6%；MDCT정학평개담관침범범위20례， MRI정학평개담관침범범위22례；MDCT정학평개혈관침범8례，MRI정학평개혈관침범7례；림파결전이급간장침범13례，MDCT정학평개10례，MRI정학평개11례。결론 MDCT급MRI대HHC적분형급수술전평고구유중요개치，대우외과수술치료구유교고적지도작용。
Objective To investigate the roles of multi-detector CT(MDCT) and magnetic resonance imaging(MRI) in the preoperative evaluation of hepatic hilar cholangiocarcinoma(HHC), and to improve the surgical resection rate of this disease. Methods 26 patients with HHC confirmed by operation and pathology were retrospectively analyzed in the study. The preoperative MDCT and MRI imaging findings of these patients were analyzed and the imaging diagnosis results were compared with operative and pathological findings. Results In the 26 patients with HHC, mass type found operatively and pathologically were 8, infiltration type 16, and intraductal nodular papilla type 2. On contrast-enhanced MDCT and MRI scans arterial phase and portal venous phase, all HHC showed mild to moderate rim enhancement. In the delayed phase, the lesions demonstrated progressive enhancement. The coincidence rate of MDCT and MRI typing were 76.9% and 84.6%, respectively. The accurate detection of bile duct involvement scope was 20 patients with MDCT, and 22 patients with MRI. MDCT correctly evaluated 8 patients with vascular invasion, and MRI did 7 patients. In the 13 patients with lymph node involvements and liver metastases, MDCT and MRI diagnosed 10 and 11 patients respectively. Conclusion MDCT and MRI play a significantly important role in the typing and preoperative evaluation of HHC. The imaging findings of MDCT and MRI have a good guiding role for surgery.
