肝内胆管囊腺瘤的MR影像诊断  

MRI diagnosis of hepatobiliary cystadenoma

作　　者：逄利博 叶惠义[2] 蔡祖龙[2] 赵汝范 崔俊凯 丁伟 

机构地区：[1]本溪市中心医院放射科,辽宁本溪117000 [2]301医院放射科,北京100853

出　　处：《中国临床医学影像杂志》2007年第7期491-494,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨肝内胆管囊腺瘤的MR检查影像表现的特征及其诊断价值。方法:经手术病理证实的肝内胆管囊腺瘤3例,2例局部可见癌变。3例均为女性,年龄39～72岁,平均52岁。常规扫描横轴位GR-T^1WI、抑脂T^2WI,其中1例行MRCP检查,采用3DLAVA或FAME序列动态增强扫描,3例均行三期及延迟期扫描。结果:3例肝内胆管囊腺瘤中1例呈囊实性结构,可见囊壁及乳头状实性肿块;1例为多个大小不等的多房囊状结构,囊壁及分隔光滑,囊壁局部明显增厚,有壁结节,周围见轻度的肝内胆管扩张;1例为巨大的多房囊状结构,囊壁及分隔光滑,局部均匀增厚;3例中的囊壁、分隔、壁结节及实性部分均呈T^2WI稍高信号、T^1WI稍低信号,囊内液性部分均呈T^2WI高信号、T^1WI低信号;肿瘤瘤体大小径线范围3.4~13.5cm。3例肝内胆管囊腺瘤中囊壁、分隔、实性肿块和壁结节动脉期均明显强化,门脉期、平衡期及延迟期强化程度略减低,强化程度均高于同期肝实质。MRCP示1例左肝内胆管分支进入到囊实性结构的瘤体内,肝内胆管均未见明显的扩张。结论:MR能明确显示肝内胆管囊腺瘤的整体影像的特征性表现,若囊壁上有结节或乳头状肿块提示局部有癌变,MR常规扫描结合动态增强及MRCP成像对肝内胆管囊腺瘤具有很高的诊断价值。Objective： To investigate the MRI manifestations and diagnostic value in patients with hepatobiliary cystadenoma. Methods： Three cases were proved by pathology to be hepatobiliary cystadenoma after surgical resection, 2 cases had portion of carcinoma. Three cases were all female, age ranged from 39 to 72 years old, mean age was 52. Conventional scan sequences were GRE-T1WI and fat saturation sequence T2WI of transaxial, MRCP was performed in 1 case, dynamic contrast enhanced scan, 3D LAVA or FAME with three phase and delay phase were performed in all. Results： MR demonstrated capsule wall and papillary solid lesions in one case with cystic and solid lesions of hepatobiliary cystadenoma. Poly cystic form structure of different size in one case, capsule wall and septation was thick, part of capsule wall was obviously thickened and nodus form, intrahepatic bile duct was dilated, large poly-antrum cystic form structure in one case, capsule wall and septation were smooth, part of capsule wall was uniformly thicken, capsule wall, septation, mural nodus form and solid lesions in three eases were all slightly hyperintense on T2WI and slightly hypointense on T1WI, part of cyst fluid was hyperintense on T2WI, the diameter of tumor ranged from 3.4cm to 13.5cm. Part of capsule wall, septation, solid lesions and mural nodus were obviously enhanced in arterial phase in three cases, the extent of enhancement showed a little degrade in port vein phase, balance phase and delay phase, but dense to liver parenchyma at synchronization. MRCP demonstrated that the branch of left intrahepatic bile duct enter the tumor of cystic and solid lesions in one case. Conclusion： MR may obviously demonstrate the entire image of hepatobiliary cystadenoma, the mural nodus form and corpora mammillaria solid lesions suggest canceration. Conventional MR sequences combine with dynamic enhancement and MRCP possess fairly diagnostic value to hepatobiliary eystadenoma.

关 键 词：囊腺瘤 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤] R445.2[医药卫生—临床医学]