原发性肝细胞癌胆管癌栓形成MRI征象分析  

The Analysis of MRI Features in Hepatocellular Carcinoma with Bile Duct Tumor Thrombi

作　　者：张文昌[1] 熊晓玲[1] 苏鸿林[1] 潘金万[1] 陈学飞[1] 邱艳梅[1] 

机构地区：[1]福建省龙岩市第二医院影像科CT/MRI室,福建龙岩364000

出　　处：《中国CT和MRI杂志》2013年第3期19-21,共3页Chinese Journal of CT and MRI

摘　　要：目的分析、总结原发性肝细胞癌胆管癌栓的MRI表现特征,提高其诊断和鉴别诊断水平。材料与方法回顾性分析9例原发性肝细胞癌胆管癌栓的MRI的影像学特征并结合临床表现。结果 6例具有原发性肝癌典型MRI征象,胆管癌栓表现为胆管内具肝动脉血供的柱状、结节状稍长T1稍长至中等长T2信号影,快速梯度回波正反相位T1WI序列5例可见高信号胆固醇结晶形成的环靶征或新月征,T1WI序列1例扩张肝内胆管呈高信号,远端肝内胆管呈软藤样或螃蟹状扩张,胆管壁未见明显受侵征象,癌栓分布于肝内胆管至胆总管的不同部位,5例合并门脉癌栓。结论原发性肝细胞癌胆管癌栓形成具有原发肿块典型的MRI表现及胆管癌栓的特征性MRI征象,结合其典型临床表现可对本病作出正确的诊断及鉴别诊断。Objective To analyze and summarize the MR1 features of hepatocellular carcinonla （HCC） with bile duct tumor thrombi. Methods 9 patients with HCC with bile duct tumor thrombi were enrolled in our investigation; the clinical data and MRI images were analyzed retrospectively. Results Typical MRI features of HCC were shown in 6 patients. The MRI manifestation of bile duct tumor th,ombi demonstrated the columnar or nodular signal with blood supplying o[＂ hepatic artery in the bile ducts^-~was slightly hypointense on TIWI and slightly to moderately hyperiniense on T2WI. 5 patients （5/9） depicted the double- target sign or crescent sign, which were formed by cholesterol crystals, were hyperintense on TIWI Fast Gradient recalled-echo. One case of bile duct dilation was hyperintense on T1WI with distal bile duct dilation as soft rattan-form, without bile duct wall tumor invasion. The tumor thrombi were distributed in different parts from inlrahepatic bile duct to common bile duct. Portal vein tumor thrombus was noted simultaneously in 5 patients. Conclusion HCC with bile duct iumor lhrombi has the typical MRI imaging features of primary tumors and the characterization MRI imaging features of bile duct tumor thrombi, in combination with the typical clinical manifestation, we can achieve the correct diagnosis and the differential diagnosis of this disease.

关 键 词：原发性肝细胞癌 胆管癌栓 MRI 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]