摘要
目的探讨CT和磁共振成像(MRI)检查在周围组织受侵犯胆囊肿瘤临床诊断中的应用价值。方法采用回顾性描述性研究方法。收集2021年1月至2022年12月国内3家医学中心收治的80例(西北大学附属第一医院21例、空军军医大学第一附属医院42例、大连医科大学附属第一医院17例)周围组织受侵犯胆囊肿瘤患者的临床病理资料;男45例,女35例;年龄为(56±4)岁。观察指标:(1)CT和MRI检查情况。(2)手术情况。正态分布的计量资料以■±s表示,偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)CT和MRI检查情况。80例患者中,胆囊癌、胆囊腺瘤分别为73、7例;腔内结节型、肿块型、局限性厚壁型分别为33、39、8例,其肿瘤大小分别为1.55 cm×1.35 cm×1.33 cm、1.64 cm×1.37 cm×1.36 cm、5.72 cm×4.07 cm×4.36 cm;腔内结节型CT检查结果示局部向腔内结节状凸起,增强扫描检查局部明显强化;局限性厚壁型CT检查结果示病变处腔壁呈局限性或弥漫性不规则增厚,厚度为1.10(1.10~2.11)cm。80例患者中,68例CT和MRI检查均提示肝实质受侵犯,可见局部肿块、分界模糊、异常性突出。68例患者肿瘤CT检查横断面、冠状位、矢状位的最大深度,最小深度,肝实质受侵犯深度分别为(4.22±0.25)cm、(4.26±0.22)cm、(4.28±0.16)cm,(0.22±0.10)cm、(0.25±0.08)cm、(0.24±0.12)cm,(1.64±1.38)cm、(1.68±1.46)cm、(1.66±1.40)cm;12例患者CT和MRI检查均提示胆囊周围组织受侵犯,表现为胃窦局部受侵犯。(2)手术情况。80例患者中,60例CT和MRI检查均提示胆囊腔内局限型肿物伴或不伴有胆囊周围组织受侵犯,并明确无其他脏器及远处转移患者行根治性切除术、姑息性切除术分别为44、16例;20例CT和MRI检查均提示胆囊恶性肿瘤伴周围肝脏浸润及肝内多发转移伴远处脏器转移患者手术不可切除。结论对胆囊周围组织受侵犯胆囊肿瘤患者,CT或MRI检查均可显示其结构特征。
Objective To investigate the application value of computed tomography(CT)and magnetic resonance imaging(MRI)examination in clinical diagnosis of gallbladder tumor with perigallbladder invasion.Methods The retrospective and descriptive study was conducted.The clinicopathological data of 80 gallbladder tumor patients with perigallbladder invasion who were admitted to 3 medical centers(21 cases in The First Affiliated Hospital of Northwest University,42 cases in The First Affiliated Hospital of the Air Force Medical University,17 cases in The First Affiliated Hospital of Dalian Medical University)from January 2021 to December 2022 were collected.There were 45 males and 35 females,aged(56±4)years.Observation indicators:(1)CT and MRI examinations;(2)surgical conditions.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were represented as M(range).Count data were described as absolute numbers.Results(1)CT and MRI examinations.Of 80 patients,cases with gallbladder cancer and gallbladder adenoma were 73 and 7,respectively.Cases with endoluminal nodular type,mass type and localized thick-walled type were 33,39 and 8,respectively,with tumor diameter as 1.55 cm×1.35 cm×1.33 cm,1.64 cm×1.37 cm×1.36 cm and 5.72 cm×4.07 cm×4.36 cm.Results of CT examination of endoluminal nodular type showed local nodular protrusions into the endoluminal area,and local enhancement on enhanced scanning.Results of CT examination of localized thick-walled type showed the cavity wall of lesion was locally or diffusely irregularly thickened,with a thickness of 1.10(range,1.10−2.21)cm.Of 80 patients,results of CT and MRI examinations showed invasion of liver parenchyma in 68 cases,which was manifested as local mass,blurred demarcation,and abnormal protrusion.The maximum depth was(4.22±0.25)cm,(4.22±0.22)cm,(4.28±0.16)cm of cross-sectional,coronal,sagittal view in CT examination,respectively.The minimum depth was(0.22±0.10)cm,(0.25±0.08)cm,(0.24±0.12)cm.The depth of liver parenchyma invaded was(1.64±1.38)cm,(1.68±1.46)cm,(1.66±1.40)cm.Results of CT and MRI examinations showed invasion of perigallbladder,which was manifested as local invasion of the gastric antrum in 12 cases.(2)Surgical conditions.Of 80 patients,results of CT and MRI examina-tions showed that 60 patients had localized masses in the gallbladder cavity with or without infiltration of surrounding tissues.After confirming the absence of other organs and distant metastasis,cases undergoing radical resection and palliative resection were 44 and 16,respectively.Results of CT and MRI examinations showed that 20 patients had malignant gallbladder tumors with peri-pheral liver infiltration and multiple intrahepatic metastases with distant organ metastases,which were unresectable.Conclusion For patients with gallbladder cancer and perigallbladder invasion,CT or MRI examinations can show their structural characteristics.
作者
范斌
和鸿
岳树强
刘亚运
李耿博
刘宇轩
顾江宁
Fan Bin;He Hong;Yue Shuqiang;Liu Yayun;Li Gengbo;Liu Yuxuan;Gu Jiangning(Department of General Surgery,The First Affiliated Hospital of Northwest University,Xi′an No.1 Hospital,Xi′an 710002,China;Department of Medical Imaging,The First Affiliated Hospital of Northwest University,Xi′an No.1 Hospital,Xi′an 710002,China;Department of Comprehensive Surgery,The First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China;School of Basic Medicine,Air Force Medical University,Xi′an 710032,China;Department of Hepatobiliary Surgery,The First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2023年第S01期73-77,共5页
Chinese Journal of Digestive Surgery
关键词
胆囊肿瘤
结构侵犯
X线计算机体层摄影
磁共振成像
影像学特征
外科手术
Gallbladder neoplasms
Structural invasion
Computer X-ray tomography
Magnetic resonance imaging
Imaging features
Surgical procedures,operative
