不典型胆囊癌的CT诊断及误、漏诊分析  

Analysis on CT diagnosis and misdiagnosis in atypical gallbladder carcinoma

作　　者：芦中庆 戴志龙[1] 侯建明[1] 

机构地区：[1]解放军第532医院,安徽黄山245041

出　　处：《临床军医杂志》2013年第8期840-842,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨不典型胆囊癌的CT表现及鉴别诊断。方法 20例经手术病理证实的不典型胆囊癌和胆囊炎,对其CT表现进行观察分析。结果本组9例胆囊癌患者中,肿块型1例(11.1%,1/9);厚壁型6例(66.7%,6/9);胆囊颈型2例(22.2%,2/9),本组11例疑似胆囊癌的胆囊炎患者中,疑似肿块型3例(27.3%,3/11);疑似厚壁型6例(54.5%,6/11);疑似腔内结节型1例(9%,1/11);疑似胆囊颈型1例(9%,1/11)。结论胆囊癌以老年女性多见,早期临床表现多不明显,不典型胆囊癌多为早期,且厚壁型多见,由于不典型胆囊癌直接征象表现多样且不易于胆囊炎鉴别,因此在诊断中仔细分析CT间接征象有利于不典型胆囊癌的早期诊断,避免误诊、漏诊的同时,对临床分期及治疗方案的制定具有重要价值。Objective To explore the CT manifestations of atypical gallbladder carcinoma and its differential diagnosis. Methods Analysis was carried out on 20 patients with pathologically confirmed atypical gallbladder carcinoma and cholecystitis. Results In the 9 cases of gallbladder cancer patients, mass type accounted for 1 （ 11.1%, 1/9）, thick-walled type for 6 （66.7%, 6/9） and gallbladder neck type for 2 cases （22.2% , 2/9 ）. In the 11 cases of gallbladder cholecystitis suspected of gallbladder cancer, sus- pected mass type accounied for 3 （27.3%, 3/11 ）, suspected thick-walled type for 6 （54.5%, 6/11 ）, suspected intraluminal nodular type for 1 （9%, 1/11 ） and suspected gallbladder neck type for 1 case（s） （9%, 1/11 ）. Conclusion Atypical gallblad- der cancer is usually early carcinomatous change, and thick-walled type is the most common one. The direct manifestations being multiple and hard to be differentiated from that of choleeystitis, it is helpful to carefully analyze the indirect signs of CT in order that the early diagnosis is made and the misdiagnosis is avoided.

关 键 词：胆囊肿瘤 分型 诊断 X线计算机体层摄影术 

分 类 号：R816.5[医药卫生—放射医学]