MRCP结合DWI对胆囊癌T分期的价值

摘要

目的 探讨常规MRI、磁共振胰胆管成像(MRCP)及扩散加权成像(DWI)序列对胆囊癌(GBC)T分期的价值.方法 回顾性分析56例经手术病理证实为GBC的患者,根据MR表现进行分期并与病理结果对照,比较有无DWI序列2种方法的准确性.结果 常规MRI、MRCP分期准确率为87.5％(49/56),对T1 vs≥T2、≤T2 vs≥T3、≤T3 vs T4病变分期敏感度、特异度、准确性分别为83.3％、98.0％、96.4％,92.3％、97.7％、96.4％,93.1％、88.8％、91.1％;结合DWI分期准确率为91.1％(51/56),对T1 vs≥T2、≤T2 vs≥T3、≤T3 vs T4病变分期敏感度、特异度、准确性分别为83.3％、98.0％、96.4％,92.3％、97.7％、96.4％,93.8％、100％、96.4％.二者差异无统计学意义(P＞0.05).结论 常规MRI、MRCP对GBC T分期准确性较高,结合DWI序列能提高分期准确性,尤其是T4期准确性.%Objective To investigate the value of conventional MRI,MR cholangiopancreatography(MRCP) and diffusion weighted imaging(DWI) in T-staging of gallbladder cancer(GBC).Methods 56 patients with histologically proven GBCs were analyzed retrospectively.Staging was performed according to MR findings and compared with pathological findings.The accuracy of the two methods with or without DWI sequence was also compared.Results The accuracy of staging of conventional MRI and MRCP was 87.5％ (49/56).The sensitivity,specificity and accuracy of conventional MRI and MRCP in the stage of lesions as T1 vs ≥T2,≤T2 vs ≥T3 and ≤T3 vs T4 were 83.3 ％/98.0 ％/96.4 ％,92.3 ％/97.7 ％/96.4 ％ and 93.1％/88.8 ％/91.1％,respectively.The accuracy of staging of conventional MRI and MRCP combined with DWI was 91.1％ (51/56).The sensitivity,specificity and accuracy of conventional MRI and MRCP combined with DWI in the stage of lesions as T1 vs ≥T2,≤T2 vs ≥T3 and ≤T3 vs T4 were 83.3％/98.0％/96.4％,92.3％/97.7％/96.4％ and 93.8％/100％/96.4％,respectively.There was no statistical difference between the two groups(P＞0.05).Conclusion Conventional MRI and MRCP provides excellent T-staging accuracy for GBC.The accuracy of T-staging can be improved by conventional MRI and MRCP combining with DWI,especially for T4 stage.