MRI对肝门部胆管癌的诊断  

MRI diagnosis of the hilar cholangiocarcinoma

作　　者：邓绍强[1] 杜勇[1] 杨汉丰[1] 鲁朝宣[1] 肖冬梅[1] 胡富碧[1] 

机构地区：[1]川北医学院附属医院放射科,四川南充637007

出　　处：《实用放射学杂志》2012年第3期399-401,共3页Journal of Practical Radiology

摘　　要：目的 探讨MRI对肝门部胆管癌的诊断及鉴别诊断价值.方法 回顾性分析25例经手术及病理证实的肝门部胆管癌的MRI表现.结果 25例肝门部胆管癌中,肝门部不规则形肿块8例.类圆形结节10例,T1WI呈低信号,T2WI呈稍高信号,其余7例平扫未见确切结节或肿块.LAVA 3D扫描肝门结节或肿块动脉期强化不明显或轻度强化,延迟强化明显.累及左肝管起始部2例,右肝管起始部4例,左右肝管汇合部10例,肝总管2例;累及门静脉左支3例,淋巴结转移12例,肝左外叶萎缩3例.25例肝内胆管均有不同程度的扩张.MRCP显示病变部位胆管中断,梗阻近端呈截断状或圆锥状18例（肝门＂空虚＂）,梗阻端呈＂鸟嘴状＂或＂鼠尾状＂狭窄7例.结论 MRI及MRCP对肝门部胆管癌的定位及定性诊断具有重要价值.Objective To study MR imaging diagnosis and differential diagnosis for hepatic hilum eholangiocarcinoma. Methods MRI findings in 25 patients of hepatic hilum cholangiocarcinoma with pathologically and surgery proved were tretrospectively ana lyzed. Results In 25 cases with hilar cholangiocarcinoma,the irregular shaped masses at porta hepatic in 8 cases,owd nodules in 10 cases were detected by MR imaging, the lesions were low signal on T1WI and slightly higher signal on T2WI, but not exact nodules or masses were found in other seven cases. The nodules or masses were not obvious or mild enhancement during portal arterial phase and delayed enhancement in LAVA 3d enhanced scanning. The tumors located in the origin of the left hepatic duct in 2 cases, the origin of the right hepatic duct in 4 cases, the join parts of left and right hepatic ducts in 10 cases and the hepatic common ducts in 2 ca ses, the left branch of portal vein involved in 3 cases, metastasis of lymph node showed in 12 cases, hepatic left lateral lobe wcre at ro phy in 3 eases. The intrahepatic hile ducts were expansion in varying degrees in 25 cases. MRCP showed interrupted ,abruptly cut off or cone like changes of the bile ducts in 18 cases（ hilar ＂emptiness＂）, break like or mouse tail changes of the bile duels in 7 cases. Conclusion MR1 and MRCP are of significant value for the localization and qualitive diagnosis of the hilar cholangiocarcinoma.

关 键 词：胆管 胆管癌 磁共振成像 磁共振胰胆管成像 

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