|
|
|
| Study on the diagnostic value of magnetic resonance cholangiopancreato-graphy combined with diffusion weighted imaging in malignant biliary obstruction |
| ZHANG Yaping1 ZHOU Wei2 ZHANG Hongshe1 FENG Haitao1 XU Tao1 BIAN Haishan1 DONG Ning1 |
1.Department of Imaging, Zhuozhou City Hospital, Hebei Province, Zhuozhou 072750, China;
2.Department of Stomatology, Baoding Second Central Hospital, Hebei Province, Zhuozhou 072750, China |
|
|
|
Abstract Objective To explore the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) combined with diffusion weighted imaging (DWI) in malignant biliary obstruction. Methods A total of 100 patients with suspected malignant biliary obstruction treated in Zhuozhou City Hospital of Hebei Province from April to November 2021 were selected. MRCP and MRCP combined with DWI were used for diagnosis respectively. The pathological results were used as the gold standard to evaluate the accuracy of the two diagnostic protocols. Results Among the 100 patients, 59 were malignant and 41 were benign. The 59 malignant lesions included 11 cases of ampullary carcinoma, 23 cases of pancreatic head carcinoma, and 25 cases of cholangiocarcinoma. The accuracy, sensitivity, and specificity of MRCP were 91.00%, 84.75%, and 95.12% respectively; the accuracy, sensitivity, and specificity of MRCP combined with DWI were 98.00%, 96.61%, and 100.00% respectively. Conclusion Compared with MRCP alone, MRCP combined with DWI has higher application value in the diagnosis of malignant biliary obstruction, and can be used as a reference index for the differential diagnosis of malignant lesions.
|
|
|
|
|
|
[1] 康莹丽，鲍海华，王理祎.MRI对泡型包虫病肝门部胆管侵犯与肝门部胆管癌鉴别诊断的价值[J].临床放射学杂志，2019，38（10）：1862-1866.
[2] 李玉春，冯翠兰，蒙志刚，等.MR扩散加权成像与不同成像序列组合对乳腺良恶性病变的诊断价值[J].中国临床医学影像杂志，2017，28（2）：95-98.
[3] 林建.CT与MRI在强直性脊柱炎骶髂关节病变诊断中的应用[J].医疗装备，2019，32（19）：27-29.
[4] 陈旭姣，刘兆玉.磁共振胰胆管成像、扩散加权成像及两者联合在胆道梗阻性疾病中的应用进展[J].中国介入影像与治疗学，2017，14（5）：318-321.
[5] 谭敏仪，曾燕妮，吴志成，等.核磁共振MRCP成像原理及成像技术[J].中国医药科学，2019，9（3）：128-130，183.
[6] 邵振江.MRI在脊柱结核患者中的诊断效果及影像学特点[J].医疗装备，2019，32（9）：28-29.
[7] 孙维高，卢定友.DWI序列ADC值联合LAVA在肝脏恶性肿瘤诊断中的应用价值探讨[J].实用肝脏病杂志，2017， 20（4）：447-450.
[8] Hirose T，Igami T，Koga K，et al. The development of an automatically produced cholangiography procedure using the reconstruction of portal-phase multidetector-row computed tomography images：preliminary experience [J]. Surg Today，2017，47（3）：365-374.
[9] 邓启明，杨新官，黄文健，等.联合多种MRI参数预测肝内肿块型胆管细胞癌分化程度的研究[J].国际医学放射学杂志，2020，43（1）：17-20，25.
[10] Lee YN，Moon JH，Choi HJ，et al. Diagnostic approach using ERCP-guided transpapillary forceps biopsy or EUS- guided fine-needle aspiration biopsy according to the nature of stricture segment for patients with suspected malignant biliary stricture [J]. Cancer Med，2017，6（3）：582-590.
[11] 章俊芹，裴仁明，马娜.MRCP对胆囊结石的诊断及应用价值分析[J].湖南师范大学学报（医学版），2020，73（2）：102-104.
[12] 吴元华，王玉涛，吴盛赞，等.壶腹部浸润性腺癌的MRI诊断与临床应用[J].医学影像学杂志，2017，27（3）：497- 501.
[13] 严达，谢锦兰，车锦连，等.磁共振胰胆管成像、肝脏三维容积快速采集动态增强扫描及扩散加权成像在诊断肝外胆管癌中的应用价值[J].广西医学，2017，39（5）：618-621.
[14] 张厚强，张伟，樊英.磁共振胰胆管造影联合不同序列成像诊断恶性胆道梗阻疾病的效果研究[J].中国医学装备，2019，16（6）：47-49.
[15] Imam S，Islam MN，Khan NA，et al. Magnetic resonance cholangiopancreatography（MRCP）evaluation of obstructive jaundice in comparison with endoscopic retrograde cholangiopancreatography（ERCP）[J]. Mymensingh Med J，2017， 26（2）：420-425.
[16] 陈清亮，张宏凯，李云，等.探讨增强CT联合MRI在胆管良恶性狭窄鉴别诊断中的价值分析[J].中国CT和MRI杂志，2019，17（2）：41-43，67.
[17] 黄贤平，周观林，钟万.钆塞酸二钠增强磁共振成像在慢性肝炎背景下小肝癌诊断中的应用价值[J].医疗装备，2019，32（11）：9-10.
[18] 高磊.磁共振胰胆管成像联合MR增强扫描对肝外胆管梗阻定位和定性诊断的研究[J].肝脏，2019，24（8）：966-967，974.
[19] 单连强，石士奎，王大巍.超声、MSCT及MRI对肝门部胆管癌的诊断价值比较[J].中国CT和MRI杂志，2019， 17（6）：85-88.
[20] 王坚，闫加艳.医源性胆管损伤后狭窄三维可视化诊治专家共识（2019版）[J].中国实用外科杂志，2019，39（8）：775-781. |
|
|
|
