Value of diffusion-weighted imaging assisted magnetic resonance cholangiopancreatography in diagnosis of extrahepatic cholangiocarcinoma

XIAO Xiao; ZHONG Ling

doi:10.19732/j.cnki.2096-6210.2019.05.007

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Value of diffusion-weighted imaging assisted magnetic resonance cholangiopancreatography in diagnosis of extrahepatic cholangiocarcinoma

更新时间：2025-12-15

- Value of diffusion-weighted imaging assisted magnetic resonance cholangiopancreatography in diagnosis of extrahepatic cholangiocarcinoma
- Vol. 28, Issue 5, Pages: 325-330(2019)
- 作者机构：
  
  1. 宜宾市疾病预防控制中心门诊部,四川,宜宾,644000
  2. 宜宾市第二人民医院 CT/MRI 室,四川,宜宾,644000
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2019.05.007
  CLC：
- Published Online：28 October 2019，
  
  Published：28 October 2019
- 稿件说明：
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肖潇,钟玲. 扩散加权成像辅助磁共振胰胆管水成像对肝外胆管癌的诊断价值[J]. 肿瘤影像学, 2019, 28(5): 325-330 https://doi.

org/10.19732/j.cnki.2096-6210.2019.05.007
肖潇,钟玲. 扩散加权成像辅助磁共振胰胆管水成像对肝外胆管癌的诊断价值[J]. 肿瘤影像学, 2019, 28(5): 325-330 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.05.007.

org/10.19732/j.cnki.2096-6210.2019.05.007 DOI：

摘要

目的：

分析扩散加权成像（diffusion-weighted imaging，DWI）辅助磁共振胰胆管水成像（magnetic resonance cholangiopancreatography，MRCP）诊断肝外胆管癌（extrahepatic cholangiocarcinoma，EHCC）的临床价值。

方法：

选择2015年2月2017年3月于宜宾市第二人民医院疑诊为EHCC的患者45例，分析DWI辅助MRCP诊断EHCC的病理学特点及其临床价值。

结果：

45例EHCC患者的组织病理学诊断结果为EHCC 30例（66.67%），胆管炎5例（11.11%），胆管结石10例（22.22%）。在低b值时，EHCC患者癌灶为较低或稍高信号，DWI表现类似常规脂肪抑制T2图像，而b=1 000/1 200 s/mm

时，EHCC患者癌灶DWI均为显著的高信号，表观扩散系数（apparent diffusion coefficient，ADC）图为低信号。与

=500 s/mm

比较，随着b值依次增加，EHCC癌灶的ADC值、信噪比值（signal to noise ratio，SNR）、对比噪声比值（contrast to noise ratio，CNR）明显降低，而信号强度比值（signal intensity ratio，SIR）明显上升（

＜0.05）。DWI辅助MRCP（

=1 000/1 200 s/mm

）诊断灵敏度为93.33%，特异度100.00%，准确率95.56%，阳性预测值100.00%，阴性预测值88.24%，明显高于单独采用MRCP诊断的结果（

＜0.05）。

结论：

DWI辅助MRCP可有效鉴别与诊断EHCC，而高b值诊断EHCC患者的临床价值更高，具有较高的灵敏度、特异度及准确率，值得临床推广应用。

Abstract

Objective:

To evaluate the value of diffusion-weighted imaging (DWI)-assisted magnetic resonance cholangiopancreatog

raphy (MRCP) in diagnosis of extrahepatic cholangiocarcinoma (EHCC).

Methods:

From Feb. 2015 to Mar. 2017

45 patients with suspected EHCC were diagnosed and treated in Yibin Second Peoples Hospital. The pathological features and clinical value of DWI combined with auxiliary pancreaticobiliary hydrocephalus in the diagnosis of EHCC were analyzed.

Results:

The histopathological findings of 45 patients with EHCC were 30 patients with EHCC (66.67%)

5 patients (11.11%) with cholangitis

and 10 patients (22.22%) with bile duct stones. At low b values

the images of DWI patients with EHCC had lower signal or slightly hyperintensity. DWI performance was similar to conventional fat-suppressed T2 images. And at

=1 000/1 200 s/mm

DWI was significantly higher in EHCC patients

and ADC images showed low signal. Compared with

=500 s/mm

with the increase of b value

the ADC value

signal to noise ratio (SNR) value and contrast to noise ratio (CNR) value of EHCC tumors decreased significantly

while the signal intensity ratio (SIR) value increased significantly (

＜0.05). The diagnostic sensitivity of DWI-assisted MRCP (

=1 000/1 200 s/mm

) was 93.33 %; the specificity was 100.00%; the accuracy rate was 95.56%; the positive predictive value was 100.00%; the negative predictive value was 88.24%. All was significantly higher than the results of MRCP diagnosis alone (

＜0.05).

Conclusion:

DWI-assisted MRCP can effectively identify and diagnose EHCC

and the high b value in the diagnosis ofEHCC patients has higher clinical value

with higher sensitivity

specificity and accuracy

worthy of clinical application.

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