(河北省保定市第一医院磁共振室 071000)

    【摘要】目的：探讨磁共振DWI与动态增强在胆管癌诊断中的价值。方法：回顾性分析23例经手术、病理证实的胆管癌(本研究胆管癌仅包括肝内胆管癌及肝门部胆管癌，且最大径线〉3cm)MRI检查资料，分析其MRI表现。结果：23例胆管癌，其中肝门部胆管癌19例，肝内胆管癌4例。MRCP显示胆管扩张、中断，肝内胆管“软藤”征，T1、T2加权像表现为胆管行程区肿块。肿块T1WI呈等低信号，T2WI呈稍高信号，信号不均匀，DWI病变以低信号为主，外周呈 “残堤样”高信号，其内示散在条片状稍高信号。23例动态增强扫描有延迟不均匀强化。结论：胆管癌的磁共振DWI与动态增强表现具有特征性，联合应用对胆管癌具有较高的诊断价值。

    【关键词】胆管癌；磁共振成像；DWI；动态增强；诊断

    【Abstract】 Goal: Discussion magnetic resonance DWI and dynamic enhancement, in the bile duct cancer diagnoses the value. Method: The review analysis 23 examples the bile duct cancer which after the surgery, the pathology confirmed (this research bile duct cancer only include in liver bile duct cancer and liver gate department bile duct cancer, and the biggest diameteral wire> 3cm) the MRI inspection material, analyzes its MRI performance. Finally: 23 example bile duct cancer, liver gate department bile duct cancer 19 examples, in liver bile duct cancer 4 examples. MRCP demonstrated that the bile duct expands, the interrupt, in the liver the bile duct “the soft cane” drafts, T1, the T2 weighting displays likely for the bile duct traveling schedule area tumour. Tumour T1WI assumes and so on low signal, T2WI assumes the slightly high signal, the signal is non-uniform, the DWI pathological change by the low signal primarily, the circumference assumes “the remnant dike type” the high signal, among them shows disperses in the strip laminated shape slightly high signal. 23 example dynamic enhancement scanning has retards the non-uniform strengthening. Conclusion: Bile duct cancer's magnetic resonance DWI and the dynamic enhancement performance has the characteristic value, the union application has the high diagnosis value to the bile duct cancer. ......