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| Analysis of imaging features of unsuspected gallbladder cancer and causes of misdiagnosis or missed diagnosis |
| LIU Yang ZHU Bin▲ HE Jian ZHOU Qun |
| Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing Medical University, Jiangsu Province, Nanjing 210008, China |
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Abstract Objective To summarize imaging fearures of unsuspected gallbladder cancer （UGC）, analyze causes of missed diagnosis or misdiagnosis and provide prevention method, in order to reduce the incidence of UGC. Methods The preoperative CT and MRI imagings of 12 UGC patients who treated in the Affiliated Drum Tower Hospital of Nanjing Medical University from January 2016 to December 2018 were retrospectively analyzed and compared with the pathological results. Results The postoperative pathology diagnosis of the 12 cases were confirmed as gallbladder cancer. There were 8 cases out of 12 cases were misdiagnosed by imaging examinations, for the intracavitary type, 7 cases were nodules cancer, and 1 case was infiltration cancer. And 4 cases out of 12 cases were miss diagnosis, the 4 cases were all linfiltration cancer and thick-walled carcinomas. Conclusion The linfiltration gallbladder cancer is easy to be missed, and the nodules gallbladder cancer is easy to be misdiagnosed. Improved understanding on the imaging signs of gallbladder diseases and used standard imaging examination techniques, the preoperative diagnosis rate of UGC will be improved.
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[1] Dixon E，Vollmer CM，Sahajpal A，et al. An Aggressive Surgical Approach Leads to Improved Survival in Patients With Gallbladder Cancer [J]. Ann Surg，2005，241（3）：385-394.
[2] Clemente G，Nuzzo G，Rose AMD，et al. Unexpected Gallbladder Cancer after Laparoscopic Cholecystectomy for Acute Cholecystitis：A Worrisome Picture [J]. J Gastrointest Surg，2012，16（8）：1462-1468.
[3] Bertran E，Heise K，Andia ME，et al. Gallbladder cancer：Incidence and survival in a high-risk area of Chile [J]. Int J Cancer，2010，127（10）：2446-2454.
[4] 姚春和，陈晨，王林，等.70例腹腔镜意外胆囊癌的临床分析[J].中国普外基础与临床杂志，2016，23（6）：738-741.
[5] KuiSunChoi，SaeByeolChoi，PyoungjaePark，et al. Clinical characteristics of incidental or unsuspected gallbladder cancers diagnosed during or after cholecystectomy：A systematic review and meta-analysis [J].世界胃肠病学杂志：英文版，2015（4）：1315-1323.
[6] 薛阳，黄文才，陈子龙，等.基于MSCT征象的逐步判别分析模型鉴别诊断良、恶性胆囊壁增厚[J].华南国防医学杂志，2018，32（7）：481-485.
[7] 周飞，袁建华，徐玉芸，等.多排螺旋CT对大于1 cm胆囊息肉性病变良恶性的鉴别分析[C].2012年浙江省放射学术年会论文集，2012：108-110.
[8] 董吉，丁炎，朱巧英，等.胆囊息肉>10mm发生肿瘤性病变的超声特征分析[J].江苏医药，2018，44（5）：546-548.
[9] 窦新民，许春苗，陈学军，等.胆囊癌CT间接征象产生原因分析[J].河北医药，2012，34（3）：372-374.
[10] 段卫星，郭彩峰.胆囊癌和肝门部胆管癌的术前评估与疗效观察[J].中国实用医药，2010，5（22）：102-103.
[11] 郑建军，徐海东.意外胆囊癌的CT和MRI影像分析[J].中华全科医学，2015，13（3）：449-452.
[12] 牛鸿九.避免意外胆囊癌漏诊方法探讨[J].基层医学论坛，2012，16（23）：2998-2999.
[13] 王宇，段文涛.原发性胆囊癌误漏诊临床分析[J].临床误诊误治，2017，30（8）：8-10.
[14] 刘景昌，刘洪涛，刘炜.原发性胆囊癌的CT诊断[J].中国基层医药，2010，17（21）：2936-2937.
[15] 吕艳，胡春洪，赖爽，等.MRCP结合DWI对胆囊癌T分期的价值[J].实用放射学杂志，2017，33（11）：1688-1691.
[16] Kitazume Y，Taura SI，Nakaminato S，et al. Diffusion-Weighted Magnetic Resonance Imaging to Differentiate Malignant from Benign Gallbladder Disorders [J]. Eur J Radiol，2016，85（4）：864-873.
[17] Lee NK，Kim S，Kim TU，et al. Diffusion-weighted MRI for differentiation of benign from malignant lesions in the gallbladder [J]. Clin Radiol，2014，69（2）：e78-e85.
[18] 曾利川，杨汉丰，徐晓雪，等.原发性胆囊癌MRI误诊分析[J].华西医学，2014，29（3）：514-516.
[19] 陈藤，吴宇.超声、MRI、CT在诊断原发性胆囊癌患者中应用[J].中国CT和MRI杂志，2015，13（11）：66-69.
[20] 梁廷波，楼健颖.胆囊切除术前影像学评估方法合理选择及评价[J].中国实用外科杂志，2015，35（9）：932-935. |
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