Caroli病的影像学表现  

Imaging appearances of Caroli disease

作　　者：彭培立[1] 齐峰 韩怀忠[3] 吕颖捷 

机构地区：[1]解放军第155中心医院放射科,河南开封475003 [2]河南省医药学校 [3]解放军第155中心医院功能诊断科

出　　处：《胃肠病学和肝病学杂志》2013年第11期1151-1154,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨Caroli病的影像表现及各种影像方法对其应用价值。方法回顾性分析经MRCP、ERCP、PTC或手术病理证实的7例Caroli病患者的影像资料,并复习相关文献。结果①超声(6例)与CT(5例)平扫检查均显示肝内囊柱形或梭形病变。②超声与CT共显示特异性征象5例:超声与CT同时显示"囊尾征"2例,CT显示"中心点征"并"索条征"1例,CT分别显示"中心点征"与"索条征"各1例。"中心点征"与"索条征"均系64排CT容积平扫结合MPR薄层重建显示。③超声与CT共显示胆管结石5例、胆囊结石1例与门脉高压症2例,并显示右肾旋转不良1例、右肾多囊肾伴结石1例。④MRCP(4例)、ERCP(2例)或PTC(1例)均直观地显示扩张胆管的部位、大小、形态、范围、扩张程度及其伴发的胆管结石和胆管炎,其特征性征象系"悬挂征",MRCP结合原始资料或常规MRI显示门脉高压性肝硬化并腹水1例、右肾旋转不良1例、右侧多囊肾伴结石1例。结论超声与CT能部分显示本病的特异征象,而ERCP、PTC与MRCP对其有确诊价值;MRCP结合原始资料或常规MRI有利于本病的分型及合并症的检出,且简便无创,应列为首选检查。Objective To evaluate the imaging appearances of Caroli disease and the application value of various imaging methods on it.Methods The imaging data of 7 patients with Caroli disease proved by MRCP,ERCP,PTC,or accompanied with histology after operation were analyzed,and relavant literature was reviewed.Results ① In all 7 cases,intrahepatic saccular/columnar or spindle shaped lesions were all depicted by ultrasound （6 cases examined by US）or non-contrast CT（5 cases examined by CT） or the both.② In 5 cases,characteristic signs of Caroli disease were found by ultrasound and CT,which included ＂cystic tail sign＂ of 2 cases depicted both by ultrasound and CT,＂centeral dot sign＂ accompanied with ＂streaks sign＂ in 1 case on CT films and ＂centeral dot sign＂ and ＂streaks sign＂ on CT films each in 1 case.The ＂centeral dot sign＂ and ＂streaks sign＂ were both detected by 64-row CT under the circumstances of volume scan and thin-slice MPR.③ Ultrasound and CT also detected bile duct stones in 5 cases,billary stone in 1 case,portal hypertensions in 2 cases,right renal malrotation in 1 case and polysystic kedney in the right accompanied with renal stone in 1 case.④ The site,size,shape,range,extence of dilated bile duct and its complications such as stone and cholangitis appeared directly and clearly on MRCP （4 cases）,ERCP （2 cases） or PTC （1 case）,and ＂hanging sign＂ was characteristic of Caroli disease on such images.Combining MRCP with MRI primary films or conventional ones,liver cirrhosis accompanied by portal hypertension and ascite in 1 case,right renal malrotation in 1 case and polysystic kedney in the right accompanied with renal stone in 1 case were diagnosed.Conclusion The specific signs of Caroli disease can be partly seen on ultrasonography and CT exam,while ERCP,PTC and MRCP have diagnostic value with certainty on it.Combining MRCP with MRI primary films or conventional ones can help identify its type and find its complications,which is simple,convenient and saf

关 键 词：CAROLI病 超声检查 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]