MRI影像特征对肝内胆管细胞癌与转移性肝癌的鉴别诊断价值

发布时间：2018-03-18 07:55

本文选题：肝内胆管细胞癌　切入点：转移性肝癌　出处：《临床放射学杂志》2015年11期 　论文类型：期刊论文

【摘要】：目的探讨MRI影像特征对肝内胆管细胞癌(IHCC)和转移性肝癌(MLC)的鉴别诊断价值。方法回顾性分析本院经手术或者穿刺病理证实的22例IHCC患者(46个病灶)和24例MLC患者(96个病灶)资料。所有患者均行肝脏MR平扫及动态增强扫描检查。分析两组患者的病灶MRI常规及动态增强信号特点及病灶的伴随征象。连续资料采用t检验,分类资料采用χ2检验或者Wilcoxon秩和检验,对两组间MRI信号特征进行比较。对病灶特征进行多因素逻辑回归分析,筛选出病灶特征中较好的鉴别诊断指标。结果病灶特征中,病灶的形状、边缘、强化方式、病灶的个数、是否单发、长径、T2WI表现、动态增强各期表现及强化方式差异有统计学意义(P0.05),进行多因素逻辑回归分析显示,病灶的形状、边缘、强化方式、T2WI表现作为两者鉴别的较好指标,分析能力达到76.9%,方程有效性χ2=113524,P0.01。伴随征象中包膜凹陷、肝叶萎缩、胆管扩张差异有统计学意义(P0.01)。结论病灶的形状、边缘、T2WI表现、强化方式是鉴别IHCC和MLC的重要影像指标,结合病灶的伴随征象(胆管扩张、包膜凹陷、肝叶萎缩)可提高鉴别诊断能力。病灶的长径、个数也有一定的鉴别诊断作用。
[Abstract]:Objective to investigate the value of MRI imaging features in differential diagnosis of intrahepatic cholangiocarcinoma (IHC) and metastatic hepatocellular carcinoma (MLC). Methods 22 cases of IHCC (46 lesions) and 24 cases of MLC confirmed by surgical or puncture pathology in our hospital were retrospectively analyzed. (96 lesions) data. All patients were examined by plain and dynamic contrast-enhanced Mr scanning of liver. The characteristics of conventional and dynamic contrast-enhanced MRI signals and accompanying signs of lesions were analyzed in both groups. The continuous data were examined by t test. 蠂 2 test or Wilcoxon rank sum test were used to compare the characteristics of MRI signals between the two groups. The multivariate logistic regression analysis was used to screen out the better differential diagnosis indexes of the lesions. The shape, edge, enhancement mode, the number of lesions, the number of lesions, the appearance of T2WI, the difference of dynamic enhancement and enhancement mode were statistically significant (P 0.05). The results of multivariate logistic regression analysis showed that the shape and edge of the lesions were different. Enhancement mode T2WI was used as a good index to distinguish the two. The analytical ability was 76.9. the equation validity was 蠂 ~ 2 / 113524 / P0.01.Conclusion the shape of lesion and the appearance of T2WI were significantly different from those of middle capsule depression, hepatic lobe atrophy and bile duct dilatation. Enhancement mode is an important imaging index for differentiating IHCC from MLC. Combining with the accompanying signs (dilatation of bile duct, concave capsule, atrophy of liver lobe), the ability of differential diagnosis can be improved. The length and number of lesions can also be used for differential diagnosis.
【作者单位】：郑州大学附属肿瘤医院放射科;
【分类号】：R445.2;R735;R445.2

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