胆管细胞型肝癌的CT、MRI及血管造影表现（附八例报告）  

Hepatic Cholangiocarcinoma:CT,MRI and Angiographic Findings(Report of 8 Cases)

作　　者：王茂强[1] 张金山[1] 曹丹庆[1] 高元桂[1] 邢占海[1] 王艳萍[1] 杨立[1] 高育[1] 

机构地区：[1]解放军总医院放射诊断科,解放军总医院病理科

出　　处：《中华放射学杂志》1995年第12期845-849,共5页Chinese Journal of Radiology

摘　　要：报告８例经手术及病理证实的胆管细胞型肝癌，主要观察其ＣＴ、ＭＲＩ及血管造影表现。８例中男６例，女２例，年龄４２～６４岁（平均５２岁）。影像学检查包括ＣＴ（８例）、ＭＲＩ（７例）及血管造影（６例），主要表现：（１）ＣＴ平扫为单发分叶状低密度块影，巨块型者密度不均；注射造影剂后４例呈边缘性增强（４／６）；１例伴有肝硬化、脾大。（２）ＭＲＩＴ＿１加权像上病变呈低信号，Ｔ＿２加权像上信号较高，５例可见搬痕结构（５／７）；注射造影剂后早期，５例呈中等度边缘型强化（５／６），延迟像中心区信号不均；肝静脉及门静脉未见受侵征象。（３）血管造影表现为供血动脉增粗，被肿瘤包埋，显示僵直、拉长，４例末梢分支呈羽毛状。综合上述表现，下列征象可提示胆管细胞型肝癌：单发分叶状肿块，内有瘢痕结构；注射造影剂后呈轻～中等度边缘性增强；血管造影显示供血动脉增粗、包埋；合并肝静脉、门静脉侵犯及肝硬化少见。The authors reported eight cases of hepatic cholangiocarcinoma proved by patholo-gy,and described the appearances of these tumors on CT,MRI and angiogram,There were six men and two women,age ranging from 42 to 64 years(mean 52 years). Six of them presented with ab-dominal pain and weight loss,a palpable mass was detected in 3 patients.α- fetoprotein level was ele-vated in one patient,CT was performed in 8 patients MRI in seven,and angiography in six,The imaging findings included:(1)The most common appearance on CT scan was a sirigle lobulated,in-homogeneous low attenuation mass.Enhanced scan were available in six cases and peripheral en-hancement was shown in four patients. Liver cirrhosis and splenomegaly were found in one patient.(2)On MRI,the tumor was hypointense relative to liver parenchyma on T_1-weighted spin-echo image and hyperintense on T_2 weighted image, a central scar was seen in five patients. On contrast en-hanced MRI,five of six had moderate ehhancement at the periphery of the mass on early stage,the central area of the mass often showed inhomogeneous enhancement on delayed scan. Invasion of the portal or hepatic vein was not shown in this series.(3)Angiography was available in six patients and all cases showed enlargement and encasement of the supplying arteries,Feather-like branches were seen in 4 patients,On the basis of our results,those imaging features,including single lobulated mass with central scar and peripheral enhancement,enlargement and encasement of the supplying arteries without venous invasion and liver cirrhosis,might be of hepatic cholangiocar-cinoma suggestive.

关 键 词：胆管细胞型 肝脏肿瘤 CT NMR 血管造影 

分 类 号：R735.704[医药卫生—肿瘤]