肝门部胆管癌门静脉受侵的MRI特征及其与Bismuth Codett分型相关性
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国家自然科学基金(81050033);四川省科技支撑计划项目(2011SZ0237)


Magneticresonance imaging characteristics of the invasion of portal vein by hilar cholangiocarcinoma: correlation with BismuthCodett classification
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    摘要:

    【摘要】 目的 利用磁共振成像(MRI)评价肝门部胆管癌门静脉受侵的征象、解剖分布及其与BismuthCodett分型的相关性。方法 回顾性分析2014年1月至2016年10月经手术、病理证实为肝门部胆管癌的住院病人40例,均行常规磁共振平扫、磁共振胰胆管造影及三维容积超快速多期动态增强扫描,利用磁共振成像观察门静脉是否受侵、受侵的征象及其解剖分布,并与肝门部胆管癌BismuthCodett分型进行对照分析。结果 肝门部胆管癌门静脉受侵率为82.5%(33/40),在磁共振图像上均表现有门静脉包埋其中、受压、变窄或者闭塞,少部分病例伴有癌栓形成(5/40),门静脉增粗(14/40),脾静脉迂曲、扩张(4/40),以及脾脏增大(5/40)。其中侵及门静脉左支12例、门静脉右支6例、门静脉主干2例,同时侵及门静脉主干、左支和右支中任意两支及以上者13例。相对BismuthCodett分型Ⅰ和Ⅱ型而言,Ⅲ和Ⅳ型肝门部胆管癌更容易侵犯门静脉(P<0.05)。结论 磁共振成像能较准确的显示肝门部胆管癌门静脉受侵的情况,对临床治疗方案的制定具有重要意义

    Abstract:

    【Abstract】 Objective To evaluate the characteristics of the invasion of portal vein in patients with hilar cholangiocarcinoma on magnetic resonance imaging (MRI), the anatomic distribution of portal vein involved and its correlation with BismuthCodett classification.Methods 40 inpatients with biopsyconfirmed hilar cholangiocarcinoma between January 2014 and October 2016 were enrolled into this study. All patients underwent routine MRI scans, magnetic resonance cholangiopancreatography and threedimensional volume of the ultrafast multiphase dynamic contrastenhanced scans (3D CE LAVA).On MRI, presence or absence and signs of the portal vein invasion, and its anatomic distribution were reviewed, and the correlation of the invasion of portal vein by hilar cholangiocarcinoma with BismuthCodett classification was assessed.Results The incidence of the invasion of portal vein by hilar cholangiocarcinoma was 82.5% (33/40). The main characteristics were embedded, compression, narrowing or occlusion of portal vein including 5 patients with tumor thrombus in the portal vein, 14 patients with broadened portal vein, 4 with broadened splenic vein and 5 with splenomegaly. The left branch, the right branch of portal vein invasion occurred in 12 and 6 cases, respectively. The main portal vein was involved in 2 cases, and the involvement of the main portal vein and its left and right branches or that of any two of the previous veins occurred in 13 cases. The type Ⅲ and Ⅳ of hilar cholangiocarcinoma were more likely to invade the portal vein than typeⅠand Ⅱ(P<0.05).Conclusion MRI can accurately show the status of portal vein invasion by hilar cholangiocarcinoma, which can be helpful for the treatment decision making.

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  • 在线发布日期: 2017-06-16
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