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常规MRI结合扩散加权成像评估胆囊癌T分期并判断其组织学分级

Combined MRI and diffuse-weighted imaging in evaluation of T-staging of gallbladder carcinoma and predicting histological grading
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摘要 目的探讨常规MRI/常规MRI结合扩散加权成像(DWI)对胆囊癌T分期评估的价值,判断表观扩散系数(ADC值)与组织学分级的关系。方法收集51例经手术病理证实为胆囊癌的患者,根据常规MRI/常规MRI结合DWI进行T分期并与病理结果比较,同时进行组间比较,测量肿瘤的ADC值,判断与T分期、TNM病理分期(pTNM分期)及病理分化程度的相关性。结果常规MRI的T分期符合率为84.3%,与病理学T分期间一致性检验好(kappa值为0.7580),结合DWI后T分期符合率为92.2%、Kappa值为0.8813。常规MRI/常规MRI结合DWIT分期符合率之间的比较,经卡方检验差异无统计学意义(χ^2=1.5111,P>0.05)。ADC值与T分期、pTNM分期、病理分化程度具有相关性(分别为r=-0.672、-0.749、0.707,均P<0.05)。结论常规MRI有助于胆囊癌T分期进行诊断,结合DWI后有助于提高T分期诊断的符合率。ADC值与T分期、pTNM分期及病理分化程度有相关性。常规MRI结合DWI可评估胆囊癌T分期,并可更好地指导临床进行手术方式的选择。 Objective To study convention MRI compared with conventional MRI combined with diffusion-weighted imaging (DWI) in the evaluation of T-staging of gallbladder carcinoma, and to determine the relationship between the apparent diffusion coefficient (ADC) value and histological grading. Methods Fifty-one patients with gallbladder carcinoma confirmed by surgery and pathology were enrolled into this study. The T-staging was performed according to conventional MRI or with conventional MRI combined with DWI and the results were compared with pathological studies. Results The ADC value of tumor was measured to determine the correlation with T staging, pTNM staging and pathological tumor differentiation. For conventional MRI, the T-staging rate was 84.3%, which was consistent with the pathological T scoring (Kappa value 0.7580). After DWI, the T staging coincidence rate was 92.2% and the Kappa value was 0.8813. A comparison between conventional MRI versus conventional MRI combined with DWI T-staging compliance rates was performed using the Chi-square test (χ^2=1.5111, P>0.05). The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation (r=-0.672,-0.749, 0.707, respectively, all P<0.05). Conclusions Conventional MRI helped in the diagnoses of T-staging in gallbladder cancer. MRI combined with DWI helped to improve the coincidence rate of T-staging. The ADC values correlated with the T-staging, pTNM staging, and pathological tumor differentiation. Conventional MRI combined with DWI better evaluated the T-staging of gallbladder cancer, and could better guide the choice of treatment methods.
作者 奇丽霞 林澜 白旭 张桃 闫萍 王海屹 叶慧义 Qi Lixia;Lin Lan;Bai Xu;Zhang Tao;Yan Ping;Wang Haiyi;Ye Huiyi(Department of Radiology,First Medical Center of PLA General Hospital,Beijing 100853,China;CT-MRI Department of Ordos Central Hospital)
出处 《中华肝胆外科杂志》 CAS CSCD 北大核心 2019年第10期741-745,共5页 Chinese Journal of Hepatobiliary Surgery
关键词 胆囊肿瘤 肿瘤分期 磁共振成像 扩散加权成像 表现扩散系数 Gallbladder neoplasms Neoplasm staging Magnetic resonance imaging Diffusion weighted imaging Apparent diffusion coefficient
作者简介 通信作者:王海屹,Email:wanghaiyi301@126.com.
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