胆囊腺瘤及腺瘤样病变的 CT表现与病理对照  

CT findings of adenoma and adenomatoid lesions of the gallbladder with correlation of pathological features

作　　者：朱宗明[1] 陈宏伟[1] 丁国良[1] 方向明[1] 张宗军[3] 龚意 杨树东[2] 邹兴农[1] 陈寅[1] 

机构地区：[1]南京医科大学附属无锡人民医院医学影像科,江苏无锡214023 [2]南京医科大学附属无锡人民医院医学病理科,江苏无锡214023 [3]南京军区南京总医院医学影像科 [4]安徽滁州市第二人民医院

出　　处：《实用放射学杂志》2012年第8期1218-1221,共4页Journal of Practical Radiology

摘　　要：探讨胆囊腺瘤（AG）及腺瘤样病变CT表现,以期提高对该病的认识。方法 回顾性分析15例经手术病理证实的胆囊AG及腺瘤样病变的CT图像及临床病理特点。结果 15例胆囊AG及腺瘤样病变中,乳头状腺瘤及管状腺瘤各4例,乳头状-管状腺瘤3例,腺瘤样息肉4例。12例单发,2例各2个病灶,1例3个病灶。CT平扫均为软组织密度,外形呈乳头状或椭圆形。病变位于胆囊体部7例,胆囊颈部及胆囊底部各4例。6例AG直径〈10.0mm,9例直径〉10.0mm,内部密度均匀,平扫CT值在30~43HU之间,增强扫描后CT值在57~120HU之间。肿瘤内无出血、钙化、囊变。病灶边界清楚,邻近胆囊壁结构完整;增强后动脉期病灶中度或明显均匀强化。6例患者合并胆囊结石。结论 AG及腺瘤样病变的CT表现具有一定的特征性,增强扫描有助于鉴别肿瘤良恶性。Objective To analyze the CT findings of adenoma of gallbladder （AG） and adenomatoid lesions, so that to improve the knowledge of these diseases. Methods CT imaging, clinical and pathological features of adenoma and adenomatoid lesions proved by pathology in 15 cases were analyzed retrospectively. Results Among the 15 cases, there were 4 cases with tubular adenoma and papillary adenoma, 3 cases with tubulopapillary adenoma, 4 cases with adenomatous polyps. The lesions were are single in 12 cases, multiple in 2 （2 lesions respectively） and one case （3 lesions）. The lsions were soft tissue density at plain CT scan with papillary or oval in shape. 7 lesions located at the body of gallbladder, 4 lesions located at the gallbladder neck and the bottom, respectively. 9 lesions were 〉10.0 mm in diameter, 6 lesions were 〈10.0 mm in diameter. On the non-enhanced computed tomography（NECT）, the tumors showed hommogeneous density ranging from 30 to 43 HU. On the contrast enhanced CT （CECT）, the tumors enhanced moderately or strongly, CT attenuation, ranged from 57 to 120 HU. The tumor with clear boundary, no bleeding, calcification or cystic degeneration were found. 6 cases were associated with cholecystolithiasis. Conclusion CT findings of AG and adenomatoid lesions are of certain characteristics. CECT scan may help differentiating the benign from malignant AG.

关 键 词：胆囊 腺瘤 腺瘤样病变 体层摄影术 X线计算机 病理 

分 类 号：R735.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]