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磁共振胆胰管造影和多层螺旋计算机断层扫描在胆管癌诊断中的准确性研究。

Investigation of the accuracy of magnetic resonance cholangiography and multi-slice spiral computed tomography in the diagnosis of cholangiocarcinoma.

作者信息

Ke Cong, Yang Tianyou, Huang Gaofeng, Gu Chunwei

机构信息

Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

J Gastrointest Oncol. 2023 Jun 30;14(3):1496-1503. doi: 10.21037/jgo-22-1294. Epub 2023 Jun 5.

Abstract

BACKGROUND

Cholangiocarcinoma (CCA) is a common malignant biliary tract tumor in clinical practice. The detection rate of multi-slice spiral computed tomography (MSCT) with a diameter of 10 mm is low, and it is easy to be misdiagnosed and missed. In addition, patients who are allergic to iodized contrast media are not eligible for MSCT screening. However, magnetic resonance cholangiopancreatography (MRCP) is non-invasive, does not require contrast injection, scans quickly, and is simple to perform. MRCP has good development rate and the ability to recognize human pancreas and biliary tract. MRCP is also non-invasive, does not require contrast injection, has fast scanning speed, and is easy to operate. In addition, MRCP has a good development rate and the ability to recognize human pancreas and biliary tract. Therefore, this study sought to analyze the accuracy of MRCP and MSCT in the diagnosis of CCA.

METHODS

In this paper, 186 patients with highly suspected CCA admitted to the Second Affiliated Hospital of Soochow University from March 2020 to May 2022 were selected for MSCT and MRCP examination. We compared the diagnostic accuracy, sensitivity and specificity of MSCT and MRCP with pathological diagnosis and the detection rate of lesions with different diameters between MSCT and MRCP. Finally, the imaging features of MSCT and MRCP of CCA were analyzed.

RESULTS

The results showed that (I) the diagnostic accuracy (95.70%), sensitivity (95.12%), and specificity (96.15%) of MRCP were higher than those of MSCT (69.89%, 60.98%, and 76.92%, respectively; P<0.05); (II) MSCT and MRCP were basically consistent with the datum (Kappa value =0.527, Kappa value =0.767, respectively); (III) the detection rate of lesions <0.5 cm in diameter of MRCP (32.05%) was higher than that of MSCT (14.00%; P<0.05); and (IV) the detection rates of lesions 0.5-1.0 cm (38.46%) and >1.0 cm (29.49%) in diameter of MRCP were lower those of MSCT (50.00%, and 36.00%, respectively; P>0.05).

CONCLUSIONS

MRCP can provide relevant imaging feature information, improve the accuracy, sensitivity and specificity of the diagnosis of bile duct carcinoma, and has a high detection rate for small diameter lesions, which has good reference, promotion and reference value.

摘要

背景

胆管癌(CCA)是临床常见的恶性胆道肿瘤。多层螺旋计算机断层扫描(MSCT)对直径10mm的胆管癌检出率较低,且易误诊漏诊。此外,对碘造影剂过敏的患者不适合进行MSCT筛查。然而,磁共振胰胆管造影(MRCP)具有无创、无需注射造影剂、扫描速度快、操作简便等优点,其对人体胰腺和胆道的显示率及识别能力良好。因此,本研究旨在分析MRCP和MSCT诊断CCA的准确性。

方法

选取2020年3月至2022年5月在苏州大学附属第二医院收治的186例高度怀疑CCA的患者,进行MSCT和MRCP检查。比较MSCT和MRCP与病理诊断的诊断准确性、敏感性和特异性,以及MSCT和MRCP对不同直径病变的检出率。最后,分析CCA的MSCT和MRCP影像学特征。

结果

结果显示,(I)MRCP的诊断准确性(95.70%)、敏感性(95.12%)和特异性(96.15%)均高于MSCT(分别为69.89%、60.98%和76.92%;P<0.05);(II)MSCT和MRCP与病理结果基本一致(Kappa值分别为0.527、0.767);(III)MRCP对直径<0.5cm病变的检出率(32.05%)高于MSCT(14.00%;P<0.05);(IV)MRCP对直径0.5 - 1.0cm(38.46%)和>1.0cm(29.49%)病变的检出率低于MSCT(分别为50.00%和36.00%;P>0.05)。

结论

MRCP能够提供相关影像学特征信息,提高胆管癌诊断的准确性、敏感性和特异性,对小直径病变具有较高的检出率,具有良好的参考、推广及借鉴价值。

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