發(fā)布時間：2019-07-05 06:25

【摘要】：目的:探討MSCT聯(lián)合腫瘤標志物(包括CA19-9、CA125、CEA、AFP)對肝內腫塊型膽管細胞癌(IMCC)的診斷及鑒別診斷價值。方法:回顧性分析74例肝占位患者(包括34例IMCC和40例非IMCC患者)的影像及臨床資料。總結、分析34例IMCC的CT表現(xiàn);比較CT單獨診斷IMCC及CT聯(lián)合腫瘤標志物(CA19-9、CA125、CEA陽性,AFP陰性)診斷IMCC的準確率;進行腫瘤大小、強化程度與腫瘤標志物的相關性分析。結果:IMCC CT表現(xiàn)為形態(tài)不規(guī)則,平掃腫瘤均呈低密度,28例腫瘤內有囊變壞死區(qū),6例體積較小者病灶內密度均勻。CT增強掃描動脈期腫瘤呈環(huán)狀、網(wǎng)格狀輕度強化者16例。門脈期和靜脈期33例呈漸進性延遲強化,門脈受侵4例,所在肝葉萎縮8例,鄰近肝包膜凹陷15例,肝門、腹膜后淋巴結轉移16例。CT單獨診斷IMCC的準確率為66.2%(49/74),CT聯(lián)合腫瘤標志物的診斷準確率為83.8%(62/74),兩者差異有統(tǒng)計學意義(P=0.000)。腫瘤大小、強化程度與腫瘤標志物的相關性無統(tǒng)計學意義(P0.05)。結論:IMCC的典型CT表現(xiàn)為動脈期輕度邊緣環(huán)狀強化,門脈期、靜脈期呈漸進性強化;CT聯(lián)合腫瘤標志物可以有效提高IMCC的診斷準確率;腫瘤大小、強化程度與腫瘤標志物無相關性。
[Abstract]:Objective: to evaluate the value of MSCT combined with tumor markers (including CA19-9,CA125,CEA,AFP) in the diagnosis and differential diagnosis of intrahepatic mass bile duct carcinoma (IMCC). Methods: the imaging and clinical data of 74 patients with liver space-occupying (including 34 patients with IMCC and 40 patients with non-IMCC) were analyzed retrospectively. The CT findings of 34 cases of IMCC were analyzed, the accuracy of CT in the diagnosis of IMCC and CT combined with tumor markers (CA19-9,CA125,CEA positive, AFP negative) was compared, and the correlation between tumor size, enhancement degree and tumor markers was analyzed. Results: IMCC CT showed irregular shape and low density on plain scan. 28 cases had cysts and necrotic areas, 6 cases had uniform density in 6 cases with smaller volume, 16 cases had annular tumors in arterial phase and 16 cases had mild enhancement in grid shape on CT enhanced scan. The portal vein phase and venous phase showed progressive delayed enhancement in 33 cases, portal vein invasion in 4 cases, lobar atrophy in 8 cases, adjacent hepatic capsule depression in 15 cases, hilar and retroperitoneal lymph node metastasis in 16 cases. The accuracy of CT alone in the diagnosis of IMCC was 66.2% (49 鈮，

本文編號：2510309