MRI动态增强结合MRCP技术在肝吸虫性胆管癌中的诊断价值

发布时间：2018-05-21 12:35

本文选题：胆管肿瘤 + 片形吸虫　；参考：《中国临床医学影像杂志》2015年01期

【摘要】：目的:探讨MRI动态增强结合磁共振胰胆管成像(MRCP)技术对肝吸虫性胆管癌的诊断价值及肝吸虫病与胆管癌的病理机制。方法:回顾性分析28例经手术或穿刺病理证实的肝吸虫性胆管癌的动态增强MRI与MRCP征象,包括肿瘤发生部位、大小、形态、信号特点、强化方式及胆管扩张特点。结果:1肿块型胆管癌:9例,表现为肝内圆形、类圆形或分叶状肿块,T1WI呈低信号或混杂信号,T2WI呈不均匀高信号,动态增强呈渐进式强化。2浸润型胆管癌:16例,表现为胆管内浸润性生长,T1WI呈低或等信号,T2WI呈不均匀高信号,动态增强呈渐进式强化。3腔内型胆管癌:3例,表现为病变区胆管腔内充盈缺损,T1WI呈低信号,T2WI呈稍高信号,Gd-DTPA动态增强呈全瘤较均匀强化。4MRCP:肿块型胆管癌表现为肿块周围肝内胆管轻~中度扩张合并肝内末梢胆管小囊状扩张;浸润型及腔内型胆管癌显示梗阻区远端胆管中~重度扩张。结论:肝吸虫感染是诱发胆管癌的重要因素,肝脏末梢胆管小囊状或杵状扩张为吸虫病较特异征象,MRI动态增强结合MRCP技术对肝吸虫性胆管癌的诊断具有重要价值。
[Abstract]:Objective: to investigate the diagnostic value of dynamic enhanced MRI combined with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of paragonimiasis cholangiocarcinoma and the pathological mechanism of clonorchiasis and cholangiocarcinoma. Methods: the dynamic enhanced MRI and MRCP features of 28 cases of hepatic paragonimiasis cholangiocarcinoma confirmed by operation or puncture pathology were analyzed retrospectively, including the location, size, shape, signal characteristics, enhancement mode and dilatation of bile duct. Results among 9 cases of tumor type cholangiocarcinoma, 9 cases showed intrahepatic roundness, round or lobular mass with low signal intensity or mixed signal intensity on T2WI, and dynamic enhancement with progressive enhancement of infiltrating cholangiocarcinoma in 16 cases. The findings were as follows: low or isointense T1WI showed heterogeneous high signal intensity on T1WI, dynamic enhancement showed progressive enhancement of 3. 3 cases of intraluminal cholangiocarcinoma, 3 cases were diagnosed as intraductal cholangiocarcinoma. The findings were as follows: T1WI showed hypointensity on T1WI and Gd-DTPA dynamic enhancement showed homogeneous enhancement of the whole tumor on T2WI. 4MRCP: the tumor type of cholangiocarcinoma showed mild to moderate dilatation of intrahepatic bile duct around the tumor and small cystic dilatation of intrahepatic bile duct. Infiltrating and intraluminal cholangiocarcinoma showed moderate to severe dilatation of distal bile duct in obstructive area. Conclusion: the infection of clonorchiasis is an important factor in inducing cholangiocarcinoma. It is valuable to diagnose hepatic paragonimitic cholangiocarcinoma by dynamic enhanced MRI combined with MRCP technique.
【作者单位】：广州市番禺区中心医院放射科;
【分类号】：R735.8;R445.2

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