目的 探讨反复发作化脓性胆管 炎并肝内胆管细胞癌(ICC)患者的MRI表 现特征及临床诊断价值。方法 选取我 院于2010年6月-2014年11月收治的264 例反复发作化脓性胆管炎患者为研究对 象,均予以磁共振成象(MRI)检查、外科 手术病理检查或穿刺活检。其中经外科 手术病理检查结果证实合并肝内胆管细 胞癌者43例(52个病灶)，以病理检查结 果为“金标准”评估MRI检查对反复发作 化脓性胆管炎并肝内胆管细胞癌临床诊 断的准确性、特异性及敏感性；分析其 MRI表现。结果 此次入组的264例反复 发作性化脓性胆管炎患者中，经外科手 术病理检查或穿刺活检确诊合并肝内胆 管细胞癌者43例(52个病灶)，占总受试 人数的16.3%；MRI检查结果显示真阴性 218例，真阳性41例，假阴性2例，假阳 性3例，诊断敏感性为95.3%(41/43)， 特异性为98.6%(218/221)，准确性为 98.1%(259/264)。结论 MRI诊断反复发作 化脓性胆管炎并肝内胆管细胞癌具有较 高的准确性、特异性及敏感性，MRI特征 明显，值得临床推广。

Objective To investigate the MRI findings of recurrent supurative colangitis complicated by intrahepatic cholangiocarcinoma and clinical diagnostic value. Methods 264 patients with recurrent suppurative cholangitis who were admitted into the hospital during June 2010 to November 2014 were selected as the research objects. All of the patients were given magnetic resonance imaging (MRI) and surgical pathological examination or biopsy. The results of surgical pathological examination certified that there 43 patients (52 lesions) complicated by intrahepatic cholangiocarcinoma. The results of pathological examination were taken as the golden standard to evaluate the accuracy, specificity and sensitivity of MRI in the clinical diagnosis of recurrent supurative colangitis complicated by intrahepatic cholangiocarcinoma. The MRI findings were analuzed. Results Among the 264 patients with recurrent supurative cholangitis in this group, there were 43 patients (52 lesions) with complicated intrahepatic cholangiocarcinoma confirmed by surgical pathological examination or biopsy, accounting for 16.3% of total number of subjects; MRI results showed that 218 cases were true negative, 41 cases true positive, 2 cases false negative and 3 cases false positive. The diagnostic sensitivity was 95.3% (41 / 43), specificity 98.6% (218/221) and the accuracy 98.1% (259/264). Conclusion MRI in the diagnosis of recurrent supurative cholangitis complicated by intrahepatic cholangiocarcinoma is of higher accuracy, sensitivity and specificity. MRI findings are obvious. It is worthy of clinical promotion.