目的 研究磁核共振成像(MRI)在胆管内乳头状癌中的临床诊断价值.方法临床纳入24例我院2015年8月至2017年8月期间收治的胆管内乳头状肿瘤患者作为研究对象,所有患者均采用CT和MRI检查,以病理检查结果作为金标准,分析CT和MRI对胆管内乳头状癌的诊断情况.结果MRI及CT共诊断胆管内乳头状癌者24例,21例经病理确诊为胆管内乳头状癌,另3例被证实为良性病变;CT诊断17例患者为胆管内乳头状癌,诊断率为80.95%;MRI检查显示20例患者为胆管内乳头状癌,诊断率为95.24%.MRI诊断准确率高于CT,P<0.05.两种检查方式在阳性预测值上对比无差异,P>0.05;MRI检查在敏感度、特异度以及阴性预测值上均高于CT检查,P<0.05.结论 CT、MRI对胆管内乳头状癌具有较好的诊断价值,影像学特征明显,其中MRI相对于CT来说对恶性肿瘤的诊断率更高,影像学表现更典型,值得临床应用及推广.
Objective To analyze the clinical diagnosis value of MRI (Magnetic Resonance Imaging) in the diagnosis of intraductal papillary neoplasm of the bile duct. Methods A total of 24 patients with intraductal papillary neoplasm of the bile duct treated from August2015 to August 2017 in our hospital were selected. All patients received the CT and MRI examination. According to the pathological results, the diagnosis value was analyzed.Results According to the pathological results, 21 cases were confirmed of intraductal papillary neoplasm of the bile duct and 3 cases were benign lesions. The CT examination indicated 17 cases and the results were proven of intraductal papillary neoplasm of the bile duct (80.95%). The MRI examination indicated 20 cases were proven with intraductal papillary neoplasm of the bile duct (95.24%); the diagnosis rate based on the MRI was higher than CT (P<0.05), the positive predictive value based on two examination methods was not significantly different (P>0.05), the sensitivity, specificity and negative predictive value based on the MRI was higher than CT (P<0.05). Conclusion Both of CT and MRI have a higher diagnostic value in intraductal papillary neoplasm of the bile duct. MRI has the higher diagnostic accuracy in the malignant tumor and more typical imaging features. It is worthy of clinical application and promotion.