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岭南现代临床外科 ›› 2012, Vol. 12 ›› Issue (05): 268-270.

• 临床研究 • 上一篇    下一篇

MRI对胆囊癌的诊断价值

林笑丰1,陈玥瑶1,刘庆余2   

  1. 1. 中山大学孙逸仙纪念医院
    2. 中山大学附属第二医院
  • 通讯作者: 林笑丰

Diagnostic Value of MRI in Primary Gallbladder Carcinoma

  • Received:2012-07-12 Revised:2012-08-01 Online:2012-10-20 Published:2012-11-06

摘要: 目的 探讨胆囊癌的MRI表现,提高胆囊癌的影像诊断水平。方法 回顾性分析47例临床诊断为胆囊癌的MRI影像学资料,其中43例经病理证实。分析胆囊癌的形态、信号、强化特点、周围结构侵犯及转移情况,并与手术及病理对照。结果 厚壁型12例,腔内型19例,肿块型16例。MRI信号T1WI为等、稍低信号,T2WI稍高、高信号,增强模式为持续或渐进性强化。20例肝内外胆管扩张,梗阻点多位于肝总管占80%。25例肝脏受侵,6例十二指肠受侵,4例网膜侵犯,3例胰腺侵犯。24例淋巴结转移,N1:9例,N2:15例,与病理符合率达83.3%。肝脏转移10例,与病理符合率为100%。根据MR的临床分期与手术分期符合率90.7%。结论 MRI能够清楚显示胆囊癌病灶,并能够准确地评价胆囊癌的周围结构侵犯及转移情况,能够准确进行临床分期,有助于制定治疗策略。

关键词: 胆囊癌, 磁共振成像, 磁共振胰胆管成像, 诊断

Abstract: Objective To investigate the imaging features of gallbladder carcinoma in magnetic resonance imaging(MRI), and to improve the diagnosis of the gallbladder carcinoma. Methods 47 patients with clinical diagnosis of gallbladder carcinoma were studied with MRI. 43 cases were verified by pathology. The MRI signs of the gallbladder carcinoma cases were analyzed and compared with the surgical and pathological findings. Result 12 cases were wall-thickening type; 19 cases were intraluminal type; 16 cases were mass type.The lesions were slightly hypointense or isointense signal in T1WI, and slightly hyperintense or hyperintense signal in T2WI. The model of enhancement isprogressive or continued.There were 20 cases combined with dilated intra/extrahepatic bile duct. The level of the obstructions were common hepatic duct in 80% cases. There were25 cases with directly invading adjacent liver parenchyma, 6 involving duodenum, 4 involving omentum and 3 involving pancreas. There were 24 cases with lymph node metastasis, including 9 cases in N1 stage and 15cases in N2 stage. There were 10 caseswith liver metastasis, all of which were diagnosed correctly.The accuracy of clinical stages according to MRI findings was 90.7% compared with surgical stages. Conclusion MRI could clearly show the gallbladder carcinoma, and accurately evaluate the spread of invasion and metastasis. MRI is helpful to making exact clinical tumor stages, which is essential to making therapeutic option.

Key words: Gallbladder carcinoma, magnetic resonance imaging, Magnetic resonance cholangiopancreatography, Diagnosis