Objective To explore the application value of magnetic resonance imaging (MRI) combined with magnetic resonance cholangiopancreatography(MRCP) in differential diagnosis between gallbladder carcinoma and gallbladder gallbladder adenomyomatosis (GBA). Methods The clinical data about 18 patients with GBA and 22 patients with gallbladder carcinoma were collected from our hospital. The MRI/MRCP was used to differentially diagnose gallbladder carcinoma and GBA. The accuracy,specificity and sensitivity of MRI combined with MRCP in diagnosis of GBA and gallbladder carcinoma were analyzed,moreover,the signs of MRI/MRCP in diagnosis of GBA and gallbladder carcinoma were also analyzed.Results The accuracy, specificity and sensitivity of MRI/MRCP in diagnosis of gallbladder carcinoma were 86.36%,92.57% and 90.55%,respectively. Except for gallbladder cavity shrinking and peribiliary fat gap exudation,there were significant differences in the other signs including gallbladder wall thickening,gallbladder wall smoothing,displaying RAS sinus,gallstones in gallbladder, calcification in gallbladder wall,clear borderline of liver and gallbladder and subserosal enhancement (P<0.05 or P <0.01). Conclusion MRI/MRCP can effectively evaluate the gallbladder wall thickness, gallbladder wall smoothing,displaying RAS sinus,gallstones in gallbladder,calcification in gallbladder wall,clear borderline of liver and gallbladder and subserosal enhancement,therefor, the imaging features mentioned above can be regarded as important indexes in differential diagnosis between GBA and gallbladder carcinoma,in which,displaying RAS sinus can significantly improve the accuracy of differential diagnosis.%目的 探讨MRI结合MRCP在胆囊癌与胆囊腺肌症(gallbladder carcinoma,GBA)鉴别诊断中的应用价值.方法 收集经术后病理证实的18例GBA及22例胆囊癌患者的临床资料,采用MRI/MRCP对胆囊癌与GBA进行鉴别诊断.分析MRI结合MRCP诊断GBA及胆囊癌的准确度、特异度以及敏感度;GBA与胆囊癌的MRI/MRCP的征象.结果 MRI/MRCP诊断胆囊癌的准确度、特异度及敏感度分别为86.36%、92.57%及90.55%.除胆囊腔缩小及胆囊周围脂肪间隙渗出改变方面的征象差异无统计学意义外(P>0.05),其余各征象(胆囊壁增厚方式、胆囊壁光整、RAS窦显示、胆囊中存在结石、胆囊壁中存在钙化现象、肝胆交界清晰以及浆膜下强化)差异有统计学意义(P<0.05).结论 MRI/MRCP能够很好地对胆囊壁厚度方式、胆囊壁是否光整、显示RAS窦、胆囊壁是否出现钙化现象、肝胆交界是否清晰以及浆膜层是否存在强化等影像学表现进行评价,上述影像学征象可作为鉴别诊断GBA与胆囊癌的重要参考指标,其中显示RAS窦可显著提高鉴别诊断地准确率.
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