肝内胆管细胞癌淋巴结转移的CT特征分析  

CT Features of the Metastatic Lymph nodes in Intraheptic Cholangiocarcinoma

作　　者：迟淑萍[1] 赵金禄[1] 张峰峰[2] 李云祥[1] 袁训伟[1] 

机构地区：[1]胜利石油管理局胜利医院影像中心,山东东营257055 [2]山东大学医学院

出　　处：《实用放射学杂志》2010年第3期364-367,共4页Journal of Practical Radiology

摘　　要：目的探讨肝内胆管细胞癌腹部淋巴结转移的CT表现。方法回顾性分析46例经手术与病理证实的肝内胆管细胞癌患者的螺旋CT表现。重点观察转移淋巴结的分布情况、大小、密度及强化表现。结果46例病人中22例出现转移（47．8％），以肝十二指肠韧带组淋巴结转移发生率最高（90．9％），其次为贲门一胃小弯一胃左淋巴结组、胰后组、腹主动脉旁组、肝总动脉组、腹腔干组，分别为36．4％、36．4％、27．3％、18．2％、13．6％；转移淋巴结呈等、略低密度，短径≥2．5cm的淋巴结容易出现坏死，增强扫描淋巴结轻、中度强化，坏死部分不强化；肿瘤分化程度与淋巴结转移有明显相关性（x2=5．601，P（0．05）。结论CT扫描可以准确观察肝内胆管细胞癌淋巴结的转移情况。Objective To investigate the CT features of metastatic lymphatic nodes in the patients with intrahepatic cholangiocar- cinoma{ICC）. Methods Fourty--six cases of ICC comfirmed histopathologically were analyzed retrospectively. The location, size, density and enhanced patterns of metastatic lymph nodes were observed. Results Of 46 cases,22 had lymphadenopathy（47.8~}. Metastatic lymph nodes were most common presented in the region of hepatoduldenal ligament{ 90.9 ~ ）, followed by cardiac--lesser curvature--left gastric artery area{ 36.4~ ） ,retropancreatic area{ 36.4~ ） , paraaortic area （ 27. 3 ~ ） , arteriae hepatica communis {18.2 ~~ }and celiac trunk（13.60~）. The metastatic lymph nodes were hypodensity or isodensity and were enhanced mildly or moder- ately after administration of contrast medium. The necrosis of lymph nodes was often occurred in those whose maximum short axis diameter ~2.5 cm. There was obvious correlation between degeneration of the tumors and lymph node metastasis. Conclusion CT can clearly depict the features of metastatic lymph nodes.

关 键 词：肝脏 胆管细胞癌 淋巴结 转移 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]