目的 探讨核磁共振成像(MRI)在 胆囊腺瘤(AG)局部恶性病变患者中的诊 断鉴别价值。方法 回顾性分析2013年3 月-2017年10月期间我院经术后病理证实 的86例AG患者的临床资料，其中局部恶性 病变15例，分析局部恶性病变与AG MRI表 现的差别。结果 71例AG与15例局部恶性 病变MRI表现中，瘤体直径、有无分叶、 形态、高信号占比、有无菜花状、基底宽 窄、强化表现及是否存在胆囊壁增厚、 胆囊动脉增粗迂曲、肝脏侵犯比较，均 存在显著差异(P<0.05)；年龄、性别、 部位、边界是否清晰、合并胆囊结石比 较，均无显著差异(P>0.05)。结论 胆囊 内局部宽基底、桑葚征减少、分叶、不 规则形态、高信号占比、明显不均匀强 化、附着处胆囊壁局限性增厚、肝脏侵犯 可作为AG局部恶性病变的MRI鉴别指标， MRI在AG局部恶性病变的诊断鉴别中具有 重要价值。

Objective To explore the diagnosis and differentiation values of magnetic resonance imaging (MRI) in patients with local malignant lesions of adenoma of gallbladder(AG). Methods The clinical data of 86 cases of AG patients confirmed by postoperative pathology in our hospital from March 2013 to October 2017 were analyzed retrospectively. Among them, 15 cases were classified as local malignant lesions, and the MRI findings of local malignant lesions and AG were analyzed. Results Among MRI of 71 cases with AG and 15 cases with local malignant lesions, there were significant differences in the tumor diameter, with lobes or not, morphology, high signal proportion, with cauliflower shape or not, basal width, enhanced performance and the presence of gallbladder wall thickening, thick and round gallbladder artery and liver invasion or not (P<0.05). There was no significant difference in the age, gender, location, whether boundary was clear or not and combined cholecystolithiasis(P>0.05). Conclusion The gallbladder local wide base, reduced mulberry signs, lobulated, irregular shape, high signal proportion, significantly uneven enhancement, the limited thickening of gallbladder wall adhesion and liver invasion can be used as the MRI identification indexes for AG local malignant lesions, and MRI is of great values in the diagnosis and differentiation of AG local malignant lesions.