[1]杨 涝,高军军.多层螺旋CT在胆道恶性肿瘤诊断中的应用价值[J].医学信息,2022,35(19):145-147.[doi:10.3969/j.issn.1006-1959.2022.19.042]
　YANG Lao,GAO Jun-jun.Application Value of Multi-slice Spiral CT in Diagnosis of Biliary Tract Malignant Tumor[J].Journal of Medical Information,2022,35(19):145-147.[doi:10.3969/j.issn.1006-1959.2022.19.042]
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多层螺旋CT在胆道恶性肿瘤诊断中的应用价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年19期
页码:
145-147
栏目:
诊疗技术
出版日期:
2022-10-01

文章信息/Info

Title:
Application Value of Multi-slice Spiral CT in Diagnosis of Biliary Tract Malignant Tumor
文章编号:
1006-1959（2022）19-0145-03
作者:
杨 涝; 高军军
（1.西安市高陵区中医医院影像科，陕西 西安 710200；2.西安大兴医院，陕西 西安 710016）
Author(s):
YANG Lao; GAO Jun-jun
(1.Department of Imaging,Xi’an Gaoling District Hospital of Traditional Chinese Medicine,Xi’an 710200,Shaanxi,China;2.Xi’an Daxing Hospital,Xi’an 710016,Shaanxi,China)
关键词:
多层螺旋CT; 肝内胆管癌; 肝外胆管癌; 胆囊癌
Keywords:
Multi-slice spiral CT; Intrahepatic cholangiocarcinoma; Extrahepatic cholangiocarcinoma; Gallbladder carcinoma
分类号:
R735.8
DOI:
10.3969/j.issn.1006-1959.2022.19.042
文献标志码:
A
摘要:
目的 研究多层螺旋CT在胆道恶性肿瘤诊断中的应用价值。方法 选取2020年6月-2021年6月我院诊治的42例疑似胆道恶性肿瘤患者为研究对象，均行多层螺旋CT检查，以病理检查结果为金标准，分析胆道恶性肿瘤诊断效能、不同类型恶性肿瘤诊断效能及征象特点。结果 多层螺旋CT诊断敏感度为94.44%、特异性为71.43%、阳性预测值为94.59%、阴性预测值77.78%、准确率为97.14%。胆囊癌诊断准确率、特异性、敏感度均高于肝内胆管癌和肝外胆管癌，且肝外胆管癌高于肝内胆管癌（P＜0.05）；恶性肿瘤胆总管、胰管扩张、边界不清晰、强化不明显、低密度征象占比高于良性肿瘤（P＜0.05）；胆囊癌CT主要表现为厚壁型、肿块型、腔内结节型，在胆囊壁厚度、是否囊腔积液、是否有结节、增强后是否强化方面存在差异；肝内胆管癌和肝外胆管癌主要表现为肿块型、管壁浸润型、腔内乳头型，在肝块密度、形状、边界、强化表现方面存在差异。结论 多层螺旋CT在胆道恶性肿瘤诊断与鉴别诊断效能较高，可有效鉴别胆囊癌、肝内胆管癌和肝外胆管癌，并且良性和恶性肿瘤CT征象存在差异，对胆道恶性肿瘤诊断具有重要的价值。
Abstract:
Objective To study the application value of multi-slice spiral CT in the diagnosis of biliary malignant tumors.Methods From June 2020 to June 2021, 42 patients with suspected biliary tract malignant tumors diagnosed and treated in our hospital were selected as subjects. All patients underwent multi-slice spiral CT examination. With pathological examination results as the gold standard, the diagnostic efficacy of biliary tract malignant tumors and the diagnostic efficacy and signs of different types of malignant tumors were analyzed.Results The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of multi-slice spiral CT were 94.44%, 71.43%, 94.59%, 77.78% and 97.14%, respectively.The diagnostic accuracy, specificity and sensitivity of gallbladder cancer were higher than those of intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, and those of extrahepatic cholangiocarcinoma were higher than those of intrahepatic cholangiocarcinoma (P<0.05). The proportions of common bile duct and pancreatic duct dilatation, unclear boundary, unobvious enhancement and low density signs in malignant tumors were higher than those in benign tumors (P<0.05). The CT manifestations of gallbladder carcinoma were mainly thick wall type, mass type and intracavity nodule type, there were differences in the thickness of gallbladder wall, whether there was cystic effusion, whether there was nodule and whether there was enhancement after enhancement. Intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma mainly presented as mass type, wall infiltrating type and intraluminal papillary type, there were differences in density, shape, boundary and enhancement of hepatic mass.Conclusion Multi-slice spiral CT has high efficiency in the diagnosis and differential diagnosis of biliary tract malignant tumors, which can effectively identify gallbladder cancer, intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma, and there are differences in CT signs between benign and malignant tumors, it has important value in the diagnosis of biliary tract malignant tumors.

参考文献/References:

[1]蔡秀军,陈鸣宇,曹佳胜.美国国家综合癌症网络肝胆肿瘤临床实践指南2020版更新解读(胆管癌部分)[J].临床外科杂志,2021,29(1):7-10.[2]刘颖斌,陈炜.重视胆囊癌的规范化诊断和治疗[J].中华外科杂志,2021,59(4):249-254.[3]张正芳,魏黎明,赵俊功.胆囊癌与貌似胆囊癌的CT征象差异分析[J].临床放射学杂志,2020,39(4):704-709.[4]叶富建.螺旋CT增强扫描在胆囊癌的诊断和鉴别诊断价值探讨[J].肝脏,2017,22(10):963-965.[5]唐卫东,邓杰文,姜超,等.64排螺旋CT联合多模式重建图像在肝门部胆管癌可切除性术前评估中的应用[J].分子影像学杂志,2020,43(4):680-683.[6]余正国,庞杰荣,全世杰.CT、MRI技术在肝内胆管癌诊断中的联合应用价值研究[J].黑龙江医药,2021,34(5):1187-1189.[7]亓燕,郭静,周秀会,等.肝内胆管细胞癌与不典型肝脓肿的CT和MRI鉴别诊断[J].医学影像学杂志,2020,30(8):1433-1436.[8]李炳荣,肖扬锐,罗项超,等.肝内胆管细胞癌与不典型肝脓肿的MRI鉴别诊断[J].中华放射学杂志,2019,53(5):370-374.[9]李章柱.256层螺旋CT在肝门部胆管癌诊治中的临床应用[D].济南:山东大学,2018.[10]方兴隆.CT增强扫描与磁共振胰胆管造影在肝内胆管癌诊断中效果对比[J].实用医学影像杂志,2018,19(4):360-361.[11]李章柱,赵巨如,姜相森,等.256层CT动态增强扫描及三维重建在肝门部胆管癌诊治中的临床应用[J].医学影像学杂志,2018,28(7):1142-1146.[12]朱国荣,何利民,邵永良.多层螺旋CT在胆道恶性肿瘤诊断价值中的应用[J].浙江创伤外科,2021,26(0):950-953.[13]张明,黄玉霞.血清肿瘤标志物、多层螺旋CT及核磁共振在诊断胆管癌中的应用比较[J].标记免疫分析与临床,2018,25(2):236-240.[14]朱飞鹏,季顾惟,刘希胜,等.多排螺旋CT评估肝门部胆管癌胆道侵犯的准确性[J].中国临床研究,2017,30(12):1593-1596.[15]周礼平,陈馨,蒋晓兰.肝门部胆管癌患者的MRI及CT影像表现及诊断价值[J].中国CT和MRI杂志,2017,15(3):78-81.[16]Boyum JH,Sheedy SP,Graham RP,et al.Hepatic Mucinous Cystic Neoplasm Versus Simple Biliary Cyst: Assessment of Distinguishing Imaging Features Using CT and MRI[J].AJR Am J Roentgenol,2021,216(2):403-411.[17]王正前,朱建设.多层螺旋CT与磁共振MRCP对胆道梗阻性疾病临床诊断的应用价值[J].中国实验诊断学,2018,25(12):57-59.[18]田新禹,依丽苏牙尔?海米提,李秀玲.多层螺旋CT在恶性低位胆道梗阻疾病诊断中的应用研究[J].中华临床医师杂志,2019,13(3):449-450.[19]乔健,赵本琦,李洁,等.多层螺旋CT对胆囊癌神经周围 侵犯术前评估的价值[J].实用放射学杂志,2020,36(9):1430-1433.

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更新日期/Last Update: 1900-01-01