周围型肝内胆管细胞癌的CT和超声双期增强的比较研究  

Peripheral intrahepaitc cholangiocarcinoma:comparison of two-phased contrast enhanced CT and contrast enhanced ultrasound

作　　者：孙灿辉[1] 李子平[1] 徐辉雄[2] 孟悛非[1] 冯仕庭[1] 范淼[1] 彭振鹏[1] 郭欢仪[1] 

机构地区：[1]中山大学附属第一医院放射科,广东广州510080 [2]中山大学附属第一医院超声科,广东广州510080

出　　处：《中国医学影像技术》2008年第1期101-103,共3页Chinese Journal of Medical Imaging Technology

基　　金：广东省科技计划项目(2005B30301015)

摘　　要：目的比较周围型肝内胆管细胞癌(PIHCC)的CT和超声双期增强的特点,探讨两种方法诊断PIHCC的价值。方法回顾性分析经手术及病理证实的20例PIHCC的CT和超声双期(动脉期和门静脉期)增强的资料。CT动脉期、门静脉期扫描时间分别为注入对比剂后25 s、60 s,超声造影分别为9～40 s、41～120 s。结果肿瘤最大径3.0～16.0 cm,位于肝左叶9例,肝右叶11例。CT双期全瘤低增强8例中超声造影7例(87.5%)表现为全瘤的低增强;CT双期环形增强12例中超声造影10例(83.3%)表现为周边环形增强。超声造影门静脉期瘤内低增强范围较动脉期扩大12例(60%)。PIHCC的CT双期增强方式与超声造影比较无统计学差异(x^2=1.33,P>0.05)。动脉期瘤内小血管CT显示4例(20%),超声造影显示10例(50%),两者比较有显著性差异(x^2=4.17,P<0.05)。结论PIHCC的CT和超声双期增强方式相似,两者均能为诊断PIHCC提供重要信息。超声双期增强显示瘤内小血管优于CT。Objective To compare two-phased contrast enhanced CT （CECT） with contrast enhanced ultrasound （CEUS） for the diagnosis of peripheral intrahepaitc cholangiocarcinoma （PIHCC）. Methods Twenty patients with PIHCC underwent both CECT and CEUS during arterial phase （25 s, 9-40 s, respectively） and portal venous phase （60 s, 41-120 s, respectively） after contrast medium administration. The findings from CEUS were compared with those from CECT. Results The size of the tumors ranged from 3.0 to 16.0 cm. The tumor located in the left lobe in 9 patients and in the right lobe in 11 patients. The hypodense enhancement at the whole tumor was seen in 8 patients on CECT and the hypoechoic enhancement was seen in 7 of 8 （87.5 %） patients on CEUS. The rimlike contrast enhancement at the tumor periphery was seen in 12 patients on CECT and was seen in 10 of 12 （83.3%） patients on CEUS. The hypoechoic enhancement area was enlarged during the portal venous phase compared with that during the arterial phase in 12 （60%） patients on CEUS. No statistical difference was observed in enhancement pattern of tumor between CECT and CEUS （χ^2= 1.33, P〉0.05）. The intratumoral small vessels were observed in 4 （20%） patients during arterial phase on CECT and 10 （50%）. patients on CEUS. The significant difference was seen in demonstrating small vessels between CECT and CEUS （χ^2=4.17 ,P〈0.05）. Conclusion Both two-phased CECT and CEUS exhibit the same enhancement pattern and provide important information for the diagnosis of PIHCC. CEUS is better than CECT for demonstrating intratumoral small vessels.

关 键 词：胆管肿瘤 体层摄影术 X线计算机 超声检查 

分 类 号：R735.8[医药卫生—肿瘤] R445[医药卫生—临床医学]