目的:探討MRI及多層螺旋CT多平面重建顯示膽囊癌對(duì)鄰近結(jié)構(gòu)侵犯的價(jià)值。方法:前瞻性分析18例(CT及MRI各9例)膽囊癌對(duì)鄰近結(jié)構(gòu)侵犯情況。CT及MRI均包括平掃及增強(qiáng)掃描,CT掃描病例除橫斷斷位外,行冠狀位、矢狀位重建;MRI病例行橫斷位、冠狀位及矢狀位掃描。結(jié)果:膽囊癌對(duì)鄰近結(jié)構(gòu)侵犯的敏感度、特異度、準(zhǔn)確度如下:①橫斷位和矢狀位顯示鄰近肝實(shí)質(zhì)侵犯分別為81.2％、100.0％、83.3％,冠狀位分別為87.5％、100.0％、88.9％;②橫斷位顯示胃竇侵犯分別為75.0％、90.0％、83.3％,冠狀位及矢狀位均分別為75.0％、80.0％、77.7％;③橫斷位顯示十二指腸侵犯分別為70.0％、75.0％、72.2％,冠狀位分別為80.0％、75.0％、77.7％,矢狀位分別為70.0％、75.0％、72.5％;④橫斷位和冠狀位顯示結(jié)腸肝曲侵犯均分別為25.0％、85.7％、72.2％,矢狀位分別為50.0％、71.4％、66.6％;⑤橫斷位和冠狀位顯示膽管侵犯均分別為75.0％、100.0％、83.3％,矢狀位分別為66.6％、100.0％、77.7％;⑥橫斷位、冠狀位及矢狀位顯示鄰近腹膜侵犯及淋巴結(jié)轉(zhuǎn)移準(zhǔn)確度均為66.6％;顯示網(wǎng)膜侵犯準(zhǔn)確度均為50.0％。結(jié)論:橫斷位、冠狀位及矢狀位顯示膽囊癌對(duì)鄰近肝實(shí)質(zhì)、胃、十二指腸、膽管侵犯的敏感度、特異度、準(zhǔn)確度較高;而顯示對(duì)結(jié)腸肝曲、腹膜、網(wǎng)膜侵犯的準(zhǔn)確度較低。
引用本文： 宋慶輪,陳衛(wèi)霞,宋彬,劉榮波,陳軍法. MRI及多層螺旋CT多平面重建顯示膽囊癌鄰近結(jié)構(gòu)侵犯. 華西醫(yī)學(xué), 2009, 24(8): 2110-2114. doi: 復(fù)制
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- 2. LEVIN B. Gallbladder carcinoma[J]. Ann Oncol,1999,10(4):129-130.
- 3. YAMAGUCHI K, CHIJIIWA S, SAIKI K, et al. Retrospective analysis of 70 operations for gallbladder carcinoma[J]. Br J Surg,1997,84(2):200-204.
- 4. TSENG J H, WAN Y L, HUNG C F, et al. Diagnosis and staging of gallbaldder carcinoma. Evaluation with dynamic MR imaging[J]. Clin Imaging,2002,26(3):177-182.
- 5. 陳忠年,沈銘昌,郭慕依.實(shí)用外科病理學(xué)[M].上海:上海醫(yī)科大學(xué)出版社,1997:408.
- 6. SOYER P, GOUHIRI M, BOUDIAF M, et al. Carcinoma of the gallbladder: Imaging features with surgical correlation[J]. AJR,1997,169(3):781-785.
- 7. CHAN K M, YEH T S, YU M C, et al. Gallbladder carcinoma with biliary invasion: clinical analysis of the differences from nonbiliary invasion[J]. World J Surg,2005,29(1):72-75.
- 8. BENOIST S, PANIS Y, FAGNIEZ P. Longterm results after curative resection for carcinoma of the gallbladder[J]. Am J Surg,1998,175(2):118-122.
- 9. YOSHIMITSU K, HONDA H, SHINOZAKI K, et al. Helical CT of the local spread of carcinoma of the gallbladder: Evaluation according to the TNM system in patients who underwent surgical resection[J]. AJR,2002,179(2):423-428.
- 10. ITO M, MISHIMA Y, SATO T. An anatomical study of the lymphatic drainage of the gallbladder[J]. Surg Radiol Anat,1991,13(2):89-103.
- 11. 張小玲,劉起旺,張輝,等.MRI、MRCP對(duì)原發(fā)性膽囊癌的診斷價(jià)值[J].臨床放射學(xué)雜志,2005,24(8):707-710.