分子影像学杂志2025，Vol.48Issue(3)：353-359,7.DOI:10.12122/j.issn.1674-4500.2025.03.15
分隔/蜂窝样强化、表观扩散系数值、血管侵犯征象可有效鉴别患者肝局灶性慢性炎性病变与胆管细胞癌
Septal/honeycomb enhancement,apparent diffusion coefficient value and vascular invasion can effectively distinguish focal chronic inflammatory lesions from cholangiocarcinoma in the liver
摘要
Abstract
Objective To compare the MRI and clinical features of focal chronic inflammatory hepatic lesions(FCIHL)with intrahepatic cholangiocarcinoma(ICC),and improve the accuracy of diagnosis.Methods A retrospective analysis was performed on 14 histologically confirmed cases of FCIHL and 27 histologically confirmed cases of ICC,from April 2019 to October 2023.All patients underwent upper abdominal MRI,including plain scan,enhanced scan,and diffusion-weighted imaging(DWI).Additionally,15 patients underwent Gd-BOPTA MRI.Two radiologists independently analyzed and summarized the clinical and imaging characteristics of both groups,with a third radiologist assessing any discrepancies in measurements.Results Compared to the ICC group,the FCIHL case exhibited higher apparent diffusion coefficient(ADC)values(P<0.05),a higher rate of septal/honeycomb enhancement(P<0.05),and a lower rate of vascular invasion(P<0.05).However,no significant differences were observed between the two groups in lesion shape,margin,maximum diameter,progressive enhancement,local liver atrophy or capsule shrinkage,abnormal perfusion around the lesion,or distal bile duct dilatation(P>0.05).The diagnostic areas under the curve(AUC)for vascular invasion,septal/honeycomb enhancement,and ADC value in differentiating FCIHL from ICC were 0.725,0.660,and 0.827,respectively.There were not statistically significant difference in differentiating FCIHL from ICC with these three signs(P>0.05).Conclusion ADC value,vascular invasion,and septal/honeycomb enhancement are valuable in differentiating FCIHL from ICC.A comprehensive and integrated analysis of these indicators can significantly enhance the accuracy and reliability of differential diagnosis between FCIHL and ICC.关键词
肝脏/局灶性/慢性炎症/胆管细胞癌/表观扩散系数/血管侵蚀/分隔/蜂窝样强化/效能Key words
liver/focal/chronic inflammation/intrahepatic cholangiocarcinoma/apparent diffusion coefficient/vascular invasion/separation/honeycomb strengthening/efficiency引用本文复制引用
刘炼,侯钦,熊健..分隔/蜂窝样强化、表观扩散系数值、血管侵犯征象可有效鉴别患者肝局灶性慢性炎性病变与胆管细胞癌[J].分子影像学杂志,2025,48(3):353-359,7.基金项目
重庆市自然科学基金资助项目(csct2019jcyj-msxmX0620) （csct2019jcyj-msxmX0620）
重庆市卫生局科学基金资助项目(2012-2-376) （2012-2-376）
