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目的 评价磁共振成像 (MRI)在肝门胆管癌检查中的用途 ,肝门胆管癌的MRI表现与组织病理学的关系。材料与方法搜集 2 4例经手术和病理证实的肝门胆管癌 ,分析肿瘤在MRI上的表现 ,包括肿瘤生长类型、自旋回波 (SE)T1和T2 WI上的信号特点以及动态增强规律 ,评价用MRI判断肿瘤累及范围的准确性 ,研究肿瘤的组织病理学特点。结果 MRI对肝门胆管癌的检出率达到 10 0 % ,其中浸润型 10例 ,外生型 13例 ,管内型 1例。所有肿块在T1WI上为低信号 ,多数肿块在T2 WI上为等或略高信号 ,动态增强表现为缓慢持续强化。多数肿块含有丰富的纤维间质 ,而癌细胞数量较少。MRI判断肝门胆管癌累及范围的准确性为 49%。结论 MRI扫描能准确检出和识别肝门胆管癌。多数肝门胆管癌具有典型MRI征象 ,该征象同组织病理学密切相关。但目前用MRI判断肿瘤侵犯范围尚欠准确。
Objective To evaluate the use of magnetic resonance imaging (MRI) in the detection of hilar cholangiocarcinoma and the relationship between MRI findings and histopathology of hilar cholangiocarcinoma. Materials and Methods Twenty-four cases of hilar cholangiocarcinoma confirmed by surgery and pathology were collected and analyzed for tumor manifestations on MRI, including tumor growth patterns, signal characteristics on spin echo (SE) T1 and T2WI, and dynamic enhancement patterns. To evaluate the accuracy of MRI in judging the extent of tumor involvement and to study the histopathological features of the tumor. Results The detection rate of MRI for hilar cholangiocarcinoma was 100%, including 10 cases of infiltrating type, 13 cases of exogenous type, and 1 case of intraductal type. All tumors showed low signal on T1WI. Most of the tumors were equally or slightly hyperintense on T2WI. The dynamic enhancement showed slow and continuous enhancement. Most of the masses are rich in fibrous stroma and there are fewer cancer cells. The accuracy of MRI in judging the range of involvement of hilar cholangiocarcinoma was 49%. Conclusion MRI scan can accurately detect and identify hilar cholangiocarcinoma. Most of the hilar cholangiocarcinomas have typical MRI features, and the signs are closely related to histopathology. However, the current use of MRI to determine the extent of tumor invasion is still not accurate.