摘要
目的:探讨磁共振胰胆管造影(MRCP)联合T1加权成像(T1WI)、T2加权成像(T2WI)和弥散加权成像(DWI)序列诊断恶性胆道梗阻性疾病的价值。方法:选取74例疑似恶性胆道梗阻患者,均进行单纯MRCP检查及MRCP联合T1WI、T2WI和DWI扫描,并与病理结果进行比较,观察比较两种扫描的良、恶性病变表观扩散系数(ADC)值。结果:74例患者中,恶性病变42例,良性病变32例;恶性病变中胆管癌20例,胰头癌14例,壶腹癌8例;MRCP联合T1WI、T2WI及DWI检查诊断恶性病变的灵敏度和阴性预测值分别为88.10%和85.71%,明显高于单纯MRCP检查,差异有统计学意义(x^2=7.683,x^2=5.153;P<0.05);MRCP联合T1WI、T2WI及DWI检查和单纯MRCP检查诊断恶性病变的特异度和阳性预测值比较差异无统计学意义;恶性病变ADC值明显低于良性病变,差异有统计学意义(t=-8.006,P<0.05);胆管癌ADC值明显低于胰头癌和壶腹癌,差异有统计学意义(t=-6.121,t=-8.172;P<0.05)。结论:MRCP联合T1WI、T2WI和DWI序列诊断恶性胆道梗阻性疾病有较高的应用价值,其中ADC值可作为客观鉴别指标。
Objective: To investigate the value of magnetic resonance cholangiopancreatography (MRCP) combined with T1 weighted imaging (T1WI), T2 weighted imaging (T2WI) and diffusion weighted imaging (DWI) in diagnosing malignant biliary tract obstructive disease. Methods: 74 patients with suspected malignant biliary tract obstruction were selected, and all of them underwent single MRCP and MRCP combined with T1WI, T2WI and DWI scans, respectively, and the results of scans were compared with the pathological results. And the apparent diffusion coefficient (ADC) of benign or malignant lesions between two scan results were observed and compared. Results: Among the 74 cases, 42 cases were malignant, 32 cases were benign. In the malignant lesions, 20 cases had cholangiocarcinoma, 14 cases had pancreatic head carcinoma and 8 cases had ampulla carcinoma. The sensitivity and negative predictive value of MRCP combined with T1WI, T2WI and DWI in diagnosing malignant lesions were 88.10% and 85.71%, respectively, which were significantly higher than those of single MRCP (x^2=7.683,x^2=5.153, P<0.05). The differences of specificity and positive predictive value between single MRCP and MRCP combined with T1WI, T2WI and DWI were no significant. And the ADC of malignant lesions [(1.20±0.20)×10^-3mm^2/s] which was significantly lower than that of benign lesions (t=-8.006, P<0.05). The ADC value of cholangiocarcinoma [(1.02±0.23)×10-3mm2/s] was significantly lower than that of pancreatic head carcinoma and ampulla carcinoma (t=-6.121, t=-8.172, P<0.05), respectively. Conclusion: MRCP combined with T1WI, T2WI and DWI sequences has a higher application value in diagnosing malignant biliary tract obstructive diseases, and the ADC value can be used as an objective identification indicator.
作者
张厚强
张伟
樊英
ZHANG Hou-qiang;ZHANG Wei;FAN Ying(Department of Radiotherapy, Neijiang No.6 People's Hospital, Neijiang 641001, China)
出处
《中国医学装备》
2019年第6期46-49,共4页
China Medical Equipment
关键词
磁共振胰胆管造影
T1加权成像
T2加权成像
弥散加权成像
表观弥散系数
恶性胆道梗阻性疾病
Magnetic resonance cholangiopancreatography
T1 weighted imaging
T2 weighted imaging
Diffusionweighted imaging
Apparent diffusion coefficient (ADC)
Malignant biliary tract obstructive diseases
