摘要
目的评价3.0TMR平扫[包括磁共振胰胆管成像(MRCP)]及肝脏快速容积采集(LAVA)技术在恶性低位胆道梗阻术前诊断及评估中的价值。资料与方法将52例经手术与病理证实为恶性低位胆道梗阻患者的MRI资料分为3组:(1)平扫(包括3DMRCP);(2)LAVA;(3)平扫+LAVA。在不知病理结果的情况下对3组资料进行判读与分析,包括病变的定位诊断、定性诊断及手术可切除性预测,并进行统计学检验。结果MR平扫(3DMRCP)、LAVA、平扫+LAVA3组对肿瘤的定位诊断准确率分别为96.2%、98.1%、100%;定性诊断准确率分别为71.2%、88.5%、94.2%,第一组与第二组、第三组间P值分别为0.028、0.002,差异有统计学意义,第二组与第三组间P=0.488,差异无统计学意义。3组资料手术可切除性预测的准确率分别为75.0%、90.4%、90.4%,第一组与第二、三组间差异有统计学意义(P=0.038)。结论3DMRCP可准确判断梗阻部位,对于病变的定位诊断具有较大的优势;LAVA技术由于可以提供更多病变的直接征象和强化特征,因此在肿瘤的定性诊断及可切除性评估中具有重要作用。
Objective To evaluate the effect of the plain MR imaging （including MRCP） and enhanced 3D LAVA techniques in the preoperative diagnosis of malignant low level biliary obstruction. Materials and Methods 1. The MR images of 52 cases of malignant 10w biliary obstruction confirmed by surgery and pathology were divided into 3 groups： Group l, plain images （including MRCP） ; group 2, dynamic LAVA images, and group 3, plain and dynamic LAVA images. The assessment was made in terms of 3 aspects including positioning diagnosis, differential diagnosis, and resectability prediction. Results The accuracy of positioning diagnosis in 3 groups were 96.2% , 98.1% and 100% , and the differential diagnosis 71.2% , 88.5% and 94.2% respectively. There were significant differences between group 1 vs group 2 （P = 0. 028 ） and group 1 vs. group 3 （ P = 0.002 ） in differential diagnosis. There was no significant difference between group 2 vs. group 3 （ P = 0. 488 ）. The accuracy of resectability evaluation in 3 groups were 75.0% , 90.4% and 90.4% , and there were significant differences between group 1 vs group 2 and group 1 vs group 3 （ P = 0. 038 ）. Conclusion 3D MRCP is very useful in positioning diagnosis of low biliary obstruction. Dynamic enhanced 3D LAVA techniques is superior to plain images（ including MRCP） in differential diagnosis of the diseases since it could offer more information about the location and enhanced characters of the lesion.
出处
《临床放射学杂志》
CSCD
北大核心
2009年第6期817-820,共4页
Journal of Clinical Radiology
基金
国家"十一五"科技支撑计划课题(编号:2007BA105B05)
