Value of conventional magnetic resonance imaging combined with magnetic resonance cholangiopancreatography for the diagnosis of portal cholangiocarcinoma / 新乡医学院学报

ABSTRACT

Objective To investigate the value of conventional magnetic resonance imaging(MRI) combined with magnetic resonance cholangiopancreatography(MRCP) for the diagnosis of portal cholangiocarcinoma (HCCA).Methods Fortysix patients with HCCA in Chaoyang Central Hospital from September 2014 to February 2016 were selected as the research subjects.The characteristics of conventional MRI and MRCP of HCCA were retrospectively analyzed.Results Among the 46 patients with HCCA,33 cases showed portal nodules or irregular lumps blurred with the adjacent tissues,13 cases showed no obvious lump.Among the 33 cases,there were 4 cases of left hepatic duct involvement,7 cases of right hepatic duct involvement,18 cases of the left and right hepatic duct confluence involvement and 4 cases of common hepatic duct involvement.The irregular lumps or portal nodules in coronal Fiesta showed equal signal and slightly higher signal in T2WI.The liver acquisition with volume acceleration (LAVA) scan of 33 cases of portal nodules or irregular lumps showed that 24 cases had no significant enhancement in arterial phase and significant enhancement in delayed phase;and 9 cases had slight enhancement in arterial phase and non significant intensification in delayed phase.The LAVA scan of the 13 cases without obvious lumps showed the thickening of the vascular wall in arterial phase,vascular stenosis,slight enhancement in arterial phase and the significant enhancement in delayed phase.The MRCP examination of 46 cases showed moderate or severe dilatation with "soft rattan like"changes in intrahepatic bile ducts.The rupture of the dilated bile duct in porta hepatis position was found in 33 cases of portal nodules or irregular lumps,and 13 cases showed " empty" or "rat tail-like" stenosis of hepatic portal.The accuracy rates of localization and qualitative diagnosis of conventional MRI in the 46 patients were 80.43％ (37/46) and 82.61％ (38/46),respectively;and those of conventional MRI combined with MRCP were 100.00％ (46/46) and 95.65％ (44/46),respectively.The accuracy rate of localization and qualitative diagnosis of HCCA by MRI combined with MRCP was significantly higher than that by conventional MRI(x2 =8.762,4.039;P ＜ 0.05).Conclusion MRI combined with MRCP has a high diagnostic value for HCCA.