目的 评价CT及MRI在中晚期胆囊癌周围脏器侵袭和转移中的诊断价值。
方法 回顾性分析我院2003年3月至2010年6月期间收治的经手术病理证实的中晚期胆囊癌患者45例,所有患者术前均同时行CT和MRI检查。
结果 ①在诊断胆囊癌方面,CT诊断符合率为93.33% (42/45),MRI诊断符合率为88.89% (40/45),二者比较差异无统计学意义(χ2=0.287 2,P>0.05)。②在诊断胆囊癌转移的敏感度方面,肝脏直接浸润和转移诊断方面CT为72.00% (18/25),MRI为92.00% (23/25);胆管受侵诊断方面CT为83.33% (5/6),MRI为100% (6/6);胰腺转移诊断方面CT为100% (3/3),MRI为100% (3/3);淋巴结转移诊断方面CT为70.00% (7/10),MRI为90.00% (9/10);腹膜、网膜转移诊断方面CT为33.33% (1/3),MRI为33.33% (1/3)。诊断胆囊癌转移的总诊断符合率CT为72.34%(34/47),MRI为89.36% (42/47),MRI明显高于CT (χ2=4.083 3,P<0.05)。
结论 MRI在诊断胆囊癌方面与CT相当,但在诊断肿瘤侵犯邻近器官及转移方面MRI略优于CT。
Citation:
林国福,程莎莎,梁健. Diagnosis of Organ Invasion and Metastasis of Gallbladder Carcinoma with CT and MRI. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(5): 562-564. doi:
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- 1. Jemal A, Siegel R, Ward E, et al.Cancer statistics, 2009 [J]CA Cancer J Clin, 2009, 59(4):225-249.
- 2. 李荫山.胆囊结石与早期胆囊癌 [J].中国实用外科杂志,1999, 19(11):10-11..
- 3. Nevin JE, Moran TJ, Kay S, et al.Carcinoma of the gallbladder:staging, treatment, and prognosis [J].Cancer, 1976,37(1):141-148.
- 4. American Joint Committee on Cancer (AJCC).Cancer Staging Manual [M].Seventh Edition.Chicago:Springer, 2010:211-217.[ 5] Tantia O, Jain M, Khanna S, et al.Incidental carcinoma gall bladder during laparoscopic cholecystectomy for symptomatic gall stone disease [J].Surg Endosc, 2009, 23(9):2041-2046.
- 5. Lazcano-Ponce EC, Miquel JF, Muñoz N, et al.Epidemiology and molecular pathology of gallbladder cancer [J].CA Cancer J Clin, 2001, 51(6):349-364.
- 6. Shukla PJ, Neve R, Barreto SG, et al.A new scoring system for gallbladder cancer (aiding treatment algorithm): an analysis of 335 patients [J].Ann Surg Oncol, 2008, 15(11):3132-3137..
- 7. Ransohoff DF, Gracie WA.Treatment of gallstones [J].Ann Intern Med, 1993, 119(7 Pt 1):606-619.
- 8. Reid KM, Ramos-De la Medina A, Donohue JH.Diagnosis and surgical management of gallbladder cancer: a review [J].J Gastrointest Surg, 2007, 11(5):671-681.
- 9. Kim JH, Kim TK, Eun HW, et al.Preoperative evaluation of gallbladder carcinoma: efficacy of combined use of MR imaging,MR cholangiography, and contrast-enhanced dual-phase three-dimensional MR angiography [J].J Magn Reson Imaging, 2002,16(6):676-684.
- 10. 张小玲, 刘起旺, 张辉, 等.MRI、MRCP 对原发性胆囊癌的诊断价值 [J].临床放射学杂志, 2005, 24(8):707-710.
- 11. Lee KF, Wong J, Li JC, et al.Polypoid lesions of the gallbladder [J].Am J Surg, 2004, 188(2):186-190.
- 12. 李鸿君, 杨文奇.胆囊癌诊断与手术治疗近况 [J].中外医学研究, 2010, 8(8):28-30..
- 13. Furlan A, Ferris JV, Hosseinzadeh K, et al.Gallbladder carcinoma update: multimodality imaging evaluation, staging, and treatment options [J].AJR Am J Roentgenol, 2008, 191(5):1440-1447.
- 14. 李守帅, 孙学军.原发性胆囊癌的早期诊断进展 [J].中国普外基础与临床杂志, 2010, 17(4):329-332..
- 15. 安力春, 李文秀, 徐建宏, 等.超声造影在胆囊占位性病变中的应用价值研究 [J].当代医学, 2009, 15(26):16-19..
- 16. Grobmyer SR, Lieberman MD, Daly JM.Gallbladder cancer in the twentieth century: single institution’s experience [J].World J Surg, 2004, 28(1):47-49.
- 17. Munir K, Bari V, Yaqoob J, et al.The role of magnetic resonance cholangiopancreatography (MRCP) in obstructive jaundice [J].J Pak Med Assoc, 2004, 54(3):128-132.
- 18. Jeng-Hwei T, Yung-Liang W, Chien-Fu H, et al.Diagnosis and staging of gallbladder carcinoma: Evaluation with dynamic MR imaging [J].Clin Imaging, 2002, 26(3):177-182.