肝胆管囊腺癌影像学表现  

Imaging Findings of Hepatic Biliary Cystadenocarcinoma

作　　者：张亮[1] 程红岩[1] 周巍[2] 龙行安[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院放射科,上海200438 [2]第二军医大学附属东方肝胆外科医院超声科,上海200438

出　　处：《实用放射学杂志》2011年第5期718-720,723,共4页Journal of Practical Radiology

摘　　要：目的 探讨肝胆管囊腺癌的CT、MRI及B超表现,提高其诊断准确率.方法 回顾性分析18例经病理证实的肝胆管囊腺癌患者,螺旋CT检查6例、MRI检查5例,B超检查7例.结果 18例肝胆管囊腺癌患者中多囊性病灶2例,16例为单囊性病灶.CT平扫及MRI T1WI均表现为囊性占位,囊内可见分隔和乳头样、条状实性突起,囊壁不均匀增厚,T2WI病灶呈高信号为主,囊内分隔及乳头样、条状实性突起呈低信号,增强后动脉期囊壁、分隔及实性部分轻度强化,门脉期进一步强化,延迟期减退但仍有强化.B超均表现肝内液性为主的囊实性混合回声团块,边界较模糊,边缘高低不平,囊内有棉絮状或乳头状赘生物.结论 平扫加动态增强CT、MRI及B超能够一定程度反映肝胆管囊腺癌的影像学特点,对于提高该疾病的诊断具有一定参考价值.Objective To evaluate the findings of spiral CT,MRI and B-ultrasound of hepatic biliary cystadenocarcinoma（ HBC）, so that to improve the accurate rate of diagnosis of this disease. Methods CT,MRI and B-ultrasound features of HBC pathologically confirmed were retrospectively analyzed. 6,5 and 7 cases were examined with spiral CT, MR imagng and B-ultrasound, respectively. Results In 18 cases,there were 2 cases with multi-cystic lesions and 16 cases with single-cystic lesion. On CT and MRI T1 WI,all ca ses showed cystic lesions, septa, papillary and striped solid protrusions could be seen inside the cysts, the walls of cysts unevenly thickened. The lesions showed high signal intensity mainly,and the septa and protrusions showed low signal intensity on T2 WI. The walls of cysts and septa as well as solid part slighdy enhanced in arterial phase after administration of contrast medium,and enhanced further at the portal venous phase,enhancement decreased at delayed phase. On B-ultrasound, the lesions appeared as liquid mainly, mixed solid and cystic echo clumps with fuzzy boundary, the edges of cysts were uneven, with cotton wool excrescence of papillary excrescence inside the cysts. Conclusion Plain and dynamic contrast-enhanced MRI, spiral CT and B-ultrasound appearances of HBC are of certain characteristics, that can improve the accuracy of diagnosis of this disease.

关 键 词：肝脏 胆管 囊腺癌 体层摄影术 X线计算机 磁共振成像 超声检查 

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