CT在黄色肉芽肿性胆囊炎诊断中的价值  

Evaluation of CT in the diagnosis of xanthogranulomatous cholecystitis

作　　者：沈训泽[1] 吴瑾秀[2] 周合山[3] 张广强[2] 杨斌[3] 

机构地区：[1]浙江省绍兴市人民医院放射科,浙江绍兴312000 [2]浙江大学医学院附属第二医院放射科,浙江杭州310009 [3]浙江省杭州市第一人民医院放射科,浙江杭州310000

出　　处：《中国临床医学影像杂志》2007年第2期123-125,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:评价CT对黄色肉芽肿性胆囊炎(XGC)的诊断及与壁厚型胆囊癌鉴别诊断的价值。方法:测量13例XGC与19例壁厚型胆囊癌的胆囊壁最大厚度,并对其以下CT征象进行分析:①胆囊壁间低密度结节或低密度带,②黏膜线,③胆囊内壁改变情况,④肝内浸润,⑤肝内胆管扩张,⑥腹膜后淋巴结肿大。结果:13例XGC平均壁厚(24.7±16.0)mm,10例病灶区出现低密度结节或低密度带,8例存在黏膜线,8例病变处胆囊内壁光整,5例出现肝内浸润,1例出现肝内段胆管扩张,均无腹膜后淋巴结肿大;而19胆囊癌平均壁厚(18.3±8.6)mm,6例病灶区出现低密度结节或低密度带,该6例且均存在黏膜线,8例病变处胆囊内壁光整,7例出现肝浸润,12例出现肝内段胆管扩张,4例腹膜后淋巴结肿大。结论:增厚的胆囊壁间出现低密度结节或低密度带,肝内胆管无扩张,是XGC诊断与鉴别诊断的关键CT征象。Objective： To access the value of CT in the diagnosis of xanthogranulomatous cholecystitis（XGC） and its differentiation from thick-wall gallbladder carcinoma. Methods： The maximum thickness of the cystic wall was measured in 13 cases of XGC and 19 cases of thick-wall gallbladder carcinoma. The following CT features were analyzed and recorded： （1）intramural hypoattenuated nodules or bands of the gallbladder, （2）mucosal line; （3）appearances of the cystic inner wall; （4）infiltration of the liver, （5）dilation of intrahepatic bile duct; （6）retreperitoneal lymphadenopathy. Results： The mean thickness of the cystic wall for XGC was （24.7±16.0）mm and （18.3±8.6）mm for gallbladder carcinoma. Intramural hypoattenuated nodules were seen in 10 patients with XGC and 6 with gallbladder carcinoma. Mucosal line was observed in 8 patients with XGC and 6 with gallbladder carcinoma. Inner wall of the gallbladder was even in 8 patients with XGC and 8 with gallbladder carcinoma. Hepatic involvement was seen in 5 patients with XGC and 7 with gallbladder carcinoma. Expansion of intrahepatic bile ducts existed in 1 patient with XGC but in 12 with gallbladder carcinoma. Retreperitoneal lymphadenopathy was observed in 4 patients with gallbladder carcinoma but none with XGC. Conclusion： Intramural hypoattenuated nodules or bands in thickened cystic wall without dilation of intrahepatic bile duct is the most valuable CT features for diagnosis of XGC and its＇ differentiation from gallbladder carcinoma.

关 键 词：胆囊炎 体层摄影术 X线计算机 

分 类 号：R575.61[医药卫生—消化系统] R814.42[医药卫生—内科学]