摘要
目的:探讨莫迪司MRI增强扫描在周围性胆管细胞癌及肝脓肿鉴别诊断中的价值,以减少误诊。方法:回顾性搜集经病理证实的22例肝脓肿及21例周围性胆管细胞癌,所有病例均行莫迪司MRI平扫和增强扫描,对比分析2组MRI表现差异。结果:周围性胆管细胞癌与肝脓肿在病灶形态、信号均匀性、边缘方面差异无统计学意义(P>0.05);2组病灶增强扫描多为渐进性强化,且DWI呈高信号,差异无统计学意义(P>0.05);2组病灶伴随征象(邻近胆管扩张、胆管结石、异常灌注及肝包膜回缩)发生率差异无统计学意义(P>0.05);肝胆期,周围性胆管细胞癌外周部呈相对低信号18例(18/21),肝脓肿外周部呈均高信号(22/22),二者比较有统计学意义(P<0.05)。结论:肝胆期,周围性胆管细胞癌外周部强化减低,而肝脓肿外周部呈持续强化,具有重要的诊断价值。
Objective: To evaluate the value of Gd-BOPTA enhanced MRI in the differential diagnosis of peripheral cholangiocarcinoma and liver abscess. Methods:22 patients with liver abscess and 21 patients with peripheral cholangiocarcinoma confirmed by pathology were retrospectively collected.All cases were underwent MRI plain and Gd-BOPTA enhanced scanning.The MRI features were compared between two groups. Results:There were no statistical significant differences in the lesion shape,heterogeneous signal and border clarity between peripheral cholangiocarcinoma and liver abscess ( P >0.05).The enhancement scans of lesions in the two groups were mostly progressive enhancement,with high DWI signal,and there were no statistical significance ( P >0.05).In the hepatobiliary phase,the periphery of the most peripheral cholangiocarcinoma showed relatively low signal (18/21,85.7%),while that of all the liver abscess showed high signal (22/22,100.0%),and the comparison between the two groups was statistically significant ( P <0.05).There were no statistical significance in the accompanied signs (including cholangiectasis,cholangiolithiasis,abnormal perfusion and hepatic capsular retraction). Conclusion:Compared with the persistent enhancement of the periphery in liver abscess,the peripheral enhancement of peripheral cholangiocarcinoma was decreased in the hepatobiliary phase,which might provide important differential diagnosis value of these two diseases.
作者
汪俐杉
汤化民
陈宝
李娜
WANG Li-shan;TANG Hua-min;CHEN Bao(Department of Radiology,Chengdu First People's Hospital,Chengdu 610000,China)
出处
《放射学实践》
北大核心
2019年第6期646-650,共5页
Radiologic Practice
关键词
莫迪司
胆管细胞癌
肝脓肿
诊断
鉴别
磁共振成像
Gd-BOPTA
Cholangiocellular carcinoma
Liver abscess
Diagnosis,differential
Magnetic resonance imaging
