摘要
目的探讨MRI对肝泡型包虫病(HAE)肝门部胆管侵犯与肝门部胆管癌(HCCA)鉴别诊断的价值。方法搜集肝门部泡型包虫病(35例)和肝门部胆管癌(20例)患者的MRI及临床资料,统计学分析二者对胆管影响的特点及胆管的侵犯率,比较二者胆管形态、管壁强化之间的差异,归纳二者T1、T2、DWI、增强扫描的影像学表现。结果 HAE肝门部胆管侵犯:肝总管并肝右管侵犯发生率71.4%(25/35);肝左管侵犯发生率28.6%(10/35);HCCA肝门部肝总管上段侵犯发生率为70%(14/20),左右肝管同时侵犯发生率为30%(6/20);二者胆管梗阻性扩张、胆管截断表现无差异(P>0.05);二者管壁增厚、管壁强化、胆管内软组织肿块影存在统计学差异(P<0.05),HCCA管壁强化发生率为100%(20/20);管壁增厚发生率为90%(18/20),胆管内软组织肿块影90%(18/20);而HAE管壁强化及管壁增厚发生率均为5.7%(2/35),无胆管内软组织肿块影。结论 HAE肝门部胆管侵犯管壁增厚强化及胆管内软组织肿块影发生率明显低于HCCA,这些征象有助于二者鉴别,对选择治疗方案和预测预后有重要的作用。
Objective To study the value of MRI in differential diagnosis of Hepatic alveolar echinoccosis and hepatic intrahepatic cholangiocarcinoma. Methods MRI and clinical data of 35 cases of hepatic portal echinococcosis and 20 cases of hilar cholangiocarcinoma diagnosed and treated by hepatobiliary surgery from January 2016 to January 2018 in our hospital were collected. Statistical analysis of the effects of the two on bile duct was performed. The differences between bile duct invasion rate,bile duct morphology and wall enhancement were analyzed,and the imaging findings of T1,T2,DWI and enhanced scan were summarized. Results HAE hepatic hilar bile duct invasion:the incidence of hepatic duct and right hepatic duct invasion was 71.4%(25/35);the incidence of left hepatic duct invasion was 28.6%(10/35);the incidence of upper hepatic hilar duct invasion was 70%(14/20),the incidence of simultaneous invasion of left and right hepatic ducts was 30%(6/20);there was no difference in bile duct obstruction and bile duct truncation,P>0.05;both wall thickening and wall enhancement. There was a statistical difference between the soft tissue masses in the bile duct,P<0.05,the incidence of HCCA wall enhancement was 100%(20/20);the wall thickening rate was 90%(18/20),and the soft tissue mass in the bile duct was observed. 90%(18/20);the incidence of HAE wall enhancement and wall thickening was 5.7%(2/35),and the soft tissue mass in the bile duct was 0.00%(0/35). Conclusion HAE hepatic hilar bile duct invasion thickening and the incidence of soft tissue mass in the bile duct are significantly lower than HCCA. These signs are helpful for the identification of the two,and have important effects on the choice of treatment plan and prognosis.
作者
康莹丽
鲍海华
王理祎
KANG Yingli;BAO Haihua;WANG Liyi(Imaging Center,the Affiliated Hospital of Qinghai University,Xining,Qinghai Province 810001,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第10期1862-1866,共5页
Journal of Clinical Radiology
基金
远程影像诊断技术在青海省农村牧区的推广应用项目资助(编号:2017-SF-158)
关键词
肝泡型包虫病
肝门部胆管癌
胆管侵犯
磁共振成像
鉴别诊断
Hepatic alveolar echinococcosis
Hilar cholangiocarcinoma
Bile duct invasion
Magnetic resonance imaging
Differential diagnosis
