胆囊癌的CT诊断及误诊分析  

CT diagnosis and misdiagnostic analysis of gallbladder carcinoma

作　　者：陶学伟[1] 王索宇[1] 张新根[1] 

机构地区：[1]江西省肿瘤医院放射科,江西南昌330029

出　　处：《中国临床医学影像杂志》2006年第4期214-216,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨CT诊断胆囊癌的价值,分析胆囊癌CT误诊原因,提高胆囊癌CT诊断水平。方法:分析手术病理证实的26例胆囊癌CT表现,术前均有CT平扫,其中19例进行了增强扫描。结果:胆囊癌女性多见,男女之比为1∶2.3,好发于50岁以上患者。本组26例胆囊癌CT表现特征可归纳为4型:①胆囊腔内肿块型2例,占7.7%(226);②胆囊壁增厚型4例,占15.4%(426);③胆囊周围浸润型9例,占34.6%(926);④混合型11例,占42.3%(1126)。合并胆囊结石11例;肝脏直接受侵犯19例;肝内外胆管扩张13例;淋巴结转移15例;肝脏转移8例;累及胰和十二指肠8例;侵犯腹壁3例;侵犯胃窦2例;侵犯肝区结肠1例。CT术前正确诊断率为73.1%(1926),CT术前误诊率为23.1%(626),漏诊1例,血清CA19-9阳性率80.8%(2126)。结论:CT诊断胆囊癌有重要价值;仔细分析胆囊癌的CT征象和误诊原因,可提高诊断正确率。Objective： To evaluate the value of CT in the diagnosis of gallbladder carcinoma and analyse the CT misdiagnostic causes of gallbladder carcinoma, in order to improve the diagnostic rate. Methods： The CT findings of twenty-six patients with gallbladder carcinoma confirmed by operation and pathology were analysed. The misdiagnostic causes were analysed and compared CT images with operation. Results： Gallbladder carcinoma is more common in female than in male. It is often found over the age of 50 years old. Four type of gallbladder carcinoma were recognized： （1）Intraluminal mass of gallbladder accounted for 7.7%（2/26）; （2）Thickening of the gallbladder wall accounted for 15.4%（4/26）; （3）Infiltrating tumor accounted for 34.6%（9/26）; （4）Mixed type accounted for 42.3%（11/26）. The major CT findings were classified as follows： mass, thicken wall, intraluminal mass, mass with stone, bileduct dilatation, direct hepatic invasion, hepatic metastasis. Conclusion： CT has important value in assessing gallbladder carcinoma. Analysis of CT characteristic of gallbladder carcinoma and misdiagnostic causes are useful in improving the diagnostic rate.

关 键 词：胆囊肿瘤 体层摄影术 X线计算机 误诊 

分 类 号：R735.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]