• 1. 中國醫(yī)科大學(xué)附屬第四醫(yī)院肝膽胰外科(遼寧沈陽 110032);;
  • 2. 中國醫(yī)科大學(xué)附屬盛京醫(yī)院膽道疝減肥外科(遼寧沈陽 110003);

目的  評價(jià)CT及MRI在中晚期膽囊癌周圍臟器侵襲和轉(zhuǎn)移中的診斷價(jià)值。
方法  回顧性分析我院2003年3月至2010年6月期間收治的經(jīng)手術(shù)病理證實(shí)的中晚期膽囊癌患者45例,所有患者術(shù)前均同時(shí)行CT和MRI檢查。
結(jié)果 ?、僭谠\斷膽囊癌方面,CT診斷符合率為93.33% (42/45),MRI診斷符合率為88.89% (40/45),二者比較差異無統(tǒng)計(jì)學(xué)意義(χ2=0.287 2,P>0.05)。②在診斷膽囊癌轉(zhuǎn)移的敏感度方面,肝臟直接浸潤和轉(zhuǎn)移診斷方面CT為72.00% (18/25),MRI為92.00% (23/25);膽管受侵診斷方面CT為83.33% (5/6),MRI為100% (6/6);胰腺轉(zhuǎn)移診斷方面CT為100% (3/3),MRI為100% (3/3);淋巴結(jié)轉(zhuǎn)移診斷方面CT為70.00% (7/10),MRI為90.00% (9/10);腹膜、網(wǎng)膜轉(zhuǎn)移診斷方面CT為33.33% (1/3),MRI為33.33% (1/3)。診斷膽囊癌轉(zhuǎn)移的總診斷符合率CT為72.34%(34/47),MRI為89.36% (42/47),MRI明顯高于CT (χ2=4.083 3,P<0.05)。
結(jié)論  MRI在診斷膽囊癌方面與CT相當(dāng),但在診斷腫瘤侵犯鄰近器官及轉(zhuǎn)移方面MRI略優(yōu)于CT。

引用本文: 林國福,程莎莎,梁健. CT 和MRI 對中晚期膽囊癌周圍臟器侵襲和轉(zhuǎn)移的診斷價(jià)值. 中國普外基礎(chǔ)與臨床雜志, 2012, 19(5): 562-564. doi: 復(fù)制

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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. 李蔭山.膽囊結(jié)石與早期膽囊癌 [J].中國實(shí)用外科雜志,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. 張小玲, 劉起旺, 張輝, 等.MRI、MRCP 對原發(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.
11. Lee KF, Wong J, Li JC, et al.Polypoid lesions of the gallbladder [J].Am J Surg, 2004, 188(2):186-190.
12. 李鴻君, 楊文奇.膽囊癌診斷與手術(shù)治療近況 [J].中外醫(yī)學(xué)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. 李守帥, 孫學(xué)軍.原發(fā)性膽囊癌的早期診斷進(jìn)展 [J].中國普外基礎(chǔ)與臨床雜志, 2010, 17(4):329-332..
15. 安力春, 李文秀, 徐建宏, 等.超聲造影在膽囊占位性病變中的應(yīng)用價(jià)值研究 [J].當(dāng)代醫(yī)學(xué), 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.
  1. 1. Jemal A, Siegel R, Ward E, et al.Cancer statistics, 2009 [J]CA Cancer J Clin, 2009, 59(4):225-249.
  2. 2. 李蔭山.膽囊結(jié)石與早期膽囊癌 [J].中國實(shí)用外科雜志,1999, 19(11):10-11..
  3. 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. 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. 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. 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. 7. Ransohoff DF, Gracie WA.Treatment of gallstones [J].Ann Intern Med, 1993, 119(7 Pt 1):606-619.
  8. 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. 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. 10. 張小玲, 劉起旺, 張輝, 等.MRI、MRCP 對原發(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.
  11. 11. Lee KF, Wong J, Li JC, et al.Polypoid lesions of the gallbladder [J].Am J Surg, 2004, 188(2):186-190.
  12. 12. 李鴻君, 楊文奇.膽囊癌診斷與手術(shù)治療近況 [J].中外醫(yī)學(xué)研究, 2010, 8(8):28-30..
  13. 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. 14. 李守帥, 孫學(xué)軍.原發(fā)性膽囊癌的早期診斷進(jìn)展 [J].中國普外基礎(chǔ)與臨床雜志, 2010, 17(4):329-332..
  15. 15. 安力春, 李文秀, 徐建宏, 等.超聲造影在膽囊占位性病變中的應(yīng)用價(jià)值研究 [J].當(dāng)代醫(yī)學(xué), 2009, 15(26):16-19..
  16. 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. 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. 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.