Albiin N, Smith I C P, Arnelo U, Lindberg B, Bergquist A, Dolenko B, Bryksina N, Bezabeh T
Division of Radiology, Department for Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Acta Radiol. 2008 Oct;49(8):855-62. doi: 10.1080/02841850802220092.
Early detection of cholangiocarcinoma (CC) is very difficult, especially in patients with primary sclerosing cholangitis (PSC) who are at increased risk of developing CC.
To evaluate 1H magnetic resonance spectroscopy ((1)H-MRS) of bile as a diagnostic marker for CC in patients with and without PSC.
The institutional review board approved the study, and all patients gave informed consent. Bile from 49 patients was sampled and investigated using 1H-MRS. MR spectra of bile samples from 45 patients (18 female; age range 22-87 years, mean age 57 years) were analyzed both conventionally and using computerized multivariate analysis. Sixteen of the patients had CC, 18 had PSC, and 11 had other benign findings.
The spectra of bile from CC patients differed from the benign group in the levels of phosphatidylcholine, bile acids, lipid, and cholesterol. It was possible to distinguish CC from benign conditions in all patients with malignancy. Two benign non-PSC patients were misclassified as malignant. The sensitivity, specificity, and accuracy were 88.9%, 87.1%, and 87.8%, respectively.
With 1H-MRS of bile, cholangiocarcinoma could be discriminated from benign biliary conditions with or without PSC.
胆管癌（CC）的早期检测非常困难，尤其是在原发性硬化性胆管炎（PSC）患者中，他们患CC的风险增加。
评估胆汁的1H磁共振波谱（（1）H-MRS）作为有或无PSC患者CC的诊断标志物。
机构审查委员会批准了该研究，所有患者均签署了知情同意书。对49例患者的胆汁进行采样并使用1H-MRS进行研究。对45例患者（18例女性；年龄范围22 - 87岁，平均年龄57岁）胆汁样本的磁共振波谱进行了常规分析和计算机多变量分析。其中16例患者患有CC，18例患有PSC，11例有其他良性发现。
CC患者胆汁的波谱在磷脂酰胆碱、胆汁酸、脂质和胆固醇水平上与良性组不同。在所有恶性肿瘤患者中能够区分CC与良性情况。两名良性非PSC患者被误分类为恶性。敏感性、特异性和准确性分别为88.9%、87.1%和87.8%。
通过胆汁的1H-MRS，可以区分有或无PSC的胆管癌与良性胆道疾病。
