中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
6期
435-439
,共5页
肝脏肿瘤%胆管细胞癌%磁共振成像
肝髒腫瘤%膽管細胞癌%磁共振成像
간장종류%담관세포암%자공진성상
Liver neoplasms%Cholangiocarcinoma%Magnetic resonance imaging
目的 探讨肝脏T1、T2期末梢型胆管细胞癌(PCC)的MRI特征及其鉴别诊断.方法 选取资料完整并经手术病理证实的T1、T2期末梢型胆管细胞癌26例患者为研究对象,并随机抽取直径小于3 cm的肝脏孤立性乏血供转移瘤(HM)23例、肝脏孤立性坏死结节(SNN) 29例作对照组.分析各组患者的MRI特征,采用x2检验或Fisher确切概率法对两组肿瘤的MRI表现进行统计学分析,并对2名医师的读片结果进行接受者操作特性(ROC)曲线分析.结果 肝脏T1、T2期末梢型胆管细胞癌呈直径小于3 cm的结节灶,10例≤2.0 cm,16例在2.0 ～3.0 cm之间,病灶边界清楚(n=22,85％)、T2W1上瘤体呈均匀稍高信号(n =23,88％),增强后病灶呈斑片状强化(n =20,77％)及对比剂向心性扩散(n=21,81％),中心与周边出现弱强化带(n=9,35％)等征象的发生率较非胆管细胞癌组高,以上因素两组差异有统计学意义(P＜0.05).2名医师阅片的ROC曲线下面积Az为0.896±0.037,敏感度为84.6％,特异性为86.5％.结论 肝脏T1、T2期末梢型胆管细胞癌MRI表现具有一定特征,结合临床病史及实验室检查,多数情况下可作出较准确的术前诊断.
目的 探討肝髒T1、T2期末梢型膽管細胞癌(PCC)的MRI特徵及其鑒彆診斷.方法 選取資料完整併經手術病理證實的T1、T2期末梢型膽管細胞癌26例患者為研究對象,併隨機抽取直徑小于3 cm的肝髒孤立性乏血供轉移瘤(HM)23例、肝髒孤立性壞死結節(SNN) 29例作對照組.分析各組患者的MRI特徵,採用x2檢驗或Fisher確切概率法對兩組腫瘤的MRI錶現進行統計學分析,併對2名醫師的讀片結果進行接受者操作特性(ROC)麯線分析.結果 肝髒T1、T2期末梢型膽管細胞癌呈直徑小于3 cm的結節竈,10例≤2.0 cm,16例在2.0 ～3.0 cm之間,病竈邊界清楚(n=22,85％)、T2W1上瘤體呈均勻稍高信號(n =23,88％),增彊後病竈呈斑片狀彊化(n =20,77％)及對比劑嚮心性擴散(n=21,81％),中心與週邊齣現弱彊化帶(n=9,35％)等徵象的髮生率較非膽管細胞癌組高,以上因素兩組差異有統計學意義(P＜0.05).2名醫師閱片的ROC麯線下麵積Az為0.896±0.037,敏感度為84.6％,特異性為86.5％.結論 肝髒T1、T2期末梢型膽管細胞癌MRI錶現具有一定特徵,結閤臨床病史及實驗室檢查,多數情況下可作齣較準確的術前診斷.
목적 탐토간장T1、T2기말소형담관세포암(PCC)적MRI특정급기감별진단.방법 선취자료완정병경수술병리증실적T1、T2기말소형담관세포암26례환자위연구대상,병수궤추취직경소우3 cm적간장고립성핍혈공전이류(HM)23례、간장고립성배사결절(SNN) 29례작대조조.분석각조환자적MRI특정,채용x2검험혹Fisher학절개솔법대량조종류적MRI표현진행통계학분석,병대2명의사적독편결과진행접수자조작특성(ROC)곡선분석.결과 간장T1、T2기말소형담관세포암정직경소우3 cm적결절조,10례≤2.0 cm,16례재2.0 ～3.0 cm지간,병조변계청초(n=22,85％)、T2W1상류체정균균초고신호(n =23,88％),증강후병조정반편상강화(n =20,77％)급대비제향심성확산(n=21,81％),중심여주변출현약강화대(n=9,35％)등정상적발생솔교비담관세포암조고,이상인소량조차이유통계학의의(P＜0.05).2명의사열편적ROC곡선하면적Az위0.896±0.037,민감도위84.6％,특이성위86.5％.결론 간장T1、T2기말소형담관세포암MRI표현구유일정특정,결합림상병사급실험실검사,다수정황하가작출교준학적술전진단.
Objective To study the MR imaging appearances in a series of patients with stages T1N0M0 and T2N0M0 peripheral cholangiocarcinoma of the liver and to differentiate these tumors from hepatic metastases and from other solitary necrotic nodules.Methods A retrospective analysis was carried out on MR examinations of 26 patients with histologically confirmed choangiocarcinoma.The imaging findings were compared with those of 2 non-choangiocarcinoma groups including 23 patients with metastasis and 29 patients with solitary necrotic nodules confirmed with surgery,biopsy or follow-up imagings.Statistical analysis included Chi-square test or Fisher's exact test and the use of receiver operating characteristic (ROC) curves.Results Peripheral choangiocarcinomas in stages T1N0M0 and T2N0M0 were less than or equal to 3 cm in diameter (10 patients,≤2 cm and 16 patients,2 cm).Common findings for cholangiocarcinoma were defined margins (n =22,85％),slightly high signal on T2W1 (n =23,88％),patchy enhancement (n =20,77％),“fill-in” enhancement from periphery toward the center (n =21,81％) and diffuse hypointensity at the periphery and center of tumor (n =9,35％).There were significant differences (P ＜ 0.05) between the choangiocarcinoma group and the non-cholangiocarcinoma group in the above imaging findings.The area under the curve (Az) for differentiating peripheral cholangiocarcinoma was 0.896 ± 0.037,sensitivity was 84.6％,and specificity was 86.5％.Conclusions Our data indicated that MRI features of peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 could be determined.MR imaging,when combined with clinical and biochemical data,provided reliable information to diagnose peripheral cholangiocarcinoma.
