肝门区胆管细胞癌的MRI诊断  

MRI in the diagnosis of hilar cholangiocarcinoma

作　　者：勾素华[1] 李丹萍[1] 申大光[1] 胡臣文[1] 

机构地区：[1]深圳市罗湖区人民医院影像科,广东深圳518001

出　　处：《现代肿瘤医学》2009年第1期89-91,共3页Journal of Modern Oncology

基　　金：深圳市科技计划项目(编号:200406165)

摘　　要：目的:探讨肝门区胆管细胞癌的MRI表现特点及其鉴别诊断。方法:12例经手术及病理证实的肝门区胆管癌,其中男8例,女4例,年龄32岁-70岁,平均58岁,均行MR I平扫及动态增强扫描。结果:12例肝门区胆管细胞癌,5例病变位于肝总管,4例位于左主肝管,3例位于右主肝管,致相应肝内胆管扩张。肿瘤组织于T1W呈稍低信号强度,T2W呈略高信号强度,增强扫描3例显示早期强化明显,9例早期强化不明显,静脉期及延迟扫描12例均有中等程度的强化,表现为肿块团块状强化,受累胆管管壁不规则增厚并环行强化,2例梗阻区腔内可见到软组织肿块,4例观察到病变远近端胆管内播散结节。结论:肝门区胆管细胞癌于T2W显示伴随高信号的扩张胆管有略高信号的肿块影,动态增强扫描肿块早期有不同程度的强化,静脉期和延迟扫描呈持续性强化是其MR I表现特点。Objective：To investigate the MRI features and differential diagnosis of hilar cholangiocarcinoma. Methods： Total of patients （ 8 males and 4 females, aged from 32 - 70 years old and mean age 58 years） of hilar cholangiocarcinoma confirmed surgically and pathologically were performed by MRI plain and dynamic enchanced scanning. Results：All the lesions （5 in common hepatic duct,4 in left main hepatic duct and 3 in right） resulted in dilatation of corresponding intrahepatic bile duct. The masses showed slight hypointensity and hyperintensity on T1WI and T2WI separately. In all 12 patients ,3 cases displayed marked enhancement in the early stage but the rest was lack of this features. The lesions enhanced moderately during portal vein and balance phase exclusively. There were massive enhancement in tumors and the involved bile ducts enhanced annularly with the walls irregularly thickened, 2 cases showed intracavitary soft tissue masses at the obstruction regions and 4 cases showed disseminated nodules around them. Conclusions：Hilar cholangiocarcinoma shows dilated bile ducts with slight hyperintense masses on T2WI. The tumors have characteristics of various enhancement mode in the early stage and enhanced continuously in the delayed phase with dynamic MRI contrast enhancement scan.

关 键 词：肝门 胆管细胞癌 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤]