A Study Of Gallbladder Carcinoma And Invasion Of Adjacent Organ Using 3D-reconstruction Of MSCT And MRI

Purpose: To evaluate the value of multi-slice spiral computed tomographyand magnetic resonance imaging and three-dimensional reconstruction indiagnosis of gallbladder carcinoma and invasion adjacent organ.Materials and Methods: Between September 2005 and December 2006,18consecutive patients(13 women and 5 men) suspected of having gallbladdercarcinoma on clinical evaluation presented to the department of radiology ofWest China Hospital for further diagnosis and treatment.The age range of thepatients was 37-72 year (mean age 58.6 years).The clinical features includedstomachache , jaundice or emaciatiom.Nine patients with CT scanreconstructed axial,coronal and saggital imaging, and nine patients with MRIscaned axial,coronal and saggital imaging directly,two without saggitalimaging reconstructed by VIBE series. 18 cases were confirmed by operationand histopathological examination.Results:(1)The 18 gallbladder carcinoma,intraluminal mass accounted for27.7% (5/18) ;infiltrative mass accounted for 38.8 % (7/18) ;local thickeningwall accounted for 33.3 % (6/18) ;(2)The sensitivity, specificity and accuracy for diagnosis of liver parenchyma invasion were:81.2 %, 100 %,83.3 % foraxial imaging, 87.5%,100%,88.9% for coronal imaging,81.2%,100%,83.3% for saggital imaging,respectively; (3)The sensitivity, specificity andaccuracy for diagnosis of stomach invasion were: 75%, 90%, 83.3% foraxial imaging, 75%, 80%, 77.7% for coronal imaging, 75%, 80%, 77.7% for saggital imaging,respectively; (4)The sensitivity, specificity andaccuracy for diagnosis of duodenum invasion were:70 %, 75 %, 72.2 % foraxial imaging, 80%, 75%, 77.7% for coronal imaging, 70%, 75%, 72.5% for saggital imaging,respectively; (5) The sensitivity, specificity andaccuracy for diagnosis of hepatic flexure of colon invasion were:25 %, 85.7%, 72.2% for axial imaging, 25 %, 85.7%, 72.2% for coronal imaging,50% , 71.4% , 66.6% for saggital imaging,respectively; (6)Thesensitivity, specificity and accuracy for diagnosis of biliary ducts invasionwere:75%, 100%, 83.3% for axial imaging, 75%, 100%, 83.3% forcoronal imaging, 66.6%, 100%, 77.7% for saggital imaging,respectively;(7)axial,coronal and saggital imaging accounted for accuracy with peritoneuminvasion were 66.6%;and omentum was 0;(8) axial,coronal and saggitalimaging accounted for accuracy with lymph nodes metastasis were 66.6 %.Conclusion: CT and MRI has important value in assessing gallbladdercarcinoma, especially advanced stage cases, The use of CT or MRI scans withcontrast enhancement can make it possible to show the features of gallbladdercarcinoma.The sensitivity, specificity and accuracy to display liverparenchyma invasion are higher than to display hepatic flexure ofcolon,peritoneum and omentum.In diagnosis of gallbladder carcinoma and inassessing the invasion of adjacent organ,CT and MRI imaging can provide important imaging information for clinical therapy, and it is very important forthe selection of treatment methods.