肝胆管囊腺瘤和囊腺癌的MRI表现及病理特点  

MRI and pathological findings of hepatic biliary cystadenoma and cystadenocarcinoma

作　　者：邱喜雄[1] 雷益[1] 许美权[2] 刘品霓[1] 冯宇宁[1] 吕嘉玲[1] 

机构地区：[1]深圳市第二人民医院放射科,广东深圳518035 [2]深圳市第二人民医院病理科,广东深圳518035

出　　处：《中国现代医学杂志》2013年第32期80-84,共5页China Journal of Modern Medicine

摘　　要：目的探讨肝胆管囊腺瘤和囊腺癌的MRI表现及病理特点,提高对肝胆管囊腺瘤和囊腺癌的影像诊断及鉴别诊断水平。方法搜集经手术病理证实的10例肝胆管囊腺瘤和囊腺癌患者的临床及影像资料,对肿块部位、大小、形态、信号、囊壁、分隔、壁结节及强化程度等MRI表现以及病理改变进行回顾性分析。结果 10例患者中,肝胆管囊腺瘤6例,囊腺癌4例;8例位于肝左叶,2例位于右叶;9例为多房囊性或囊实性,1例为单房,囊内均为液体信号,其中1例伴有出血T1WI/T2WI均为高信号;6例囊腺瘤及2例囊腺癌形态规则,2例囊腺癌形态不规则;6例囊腺瘤囊壁及分隔纤细均匀,呈轻-中度延迟强化;4例囊腺癌囊壁、壁结节及分隔厚薄不均,可见不同程度延迟强化,1例明显不均匀强化。免疫组织化学:10例患者CK(AEl/AE3)及CKl9均表达阳性(+);AFP及CK20均表达阴性(-)。结论肝胆管囊腺瘤和囊腺癌MRI具有特征性表现,根据肿块囊液、囊壁、壁结节及分隔情况有助于囊腺瘤和囊腺癌的诊断及鉴别诊断。[Objective] To study the MRI findings and pathological features of the hepatic biliary cys tadenoma and cystadenocarcinoma in order to improve the cognition and diagnosis in clinic. [Methods] The MRI and clinical data of 10 cases with surgery and pathology proved hepatic biliary cystadenoma and cys tadenocarcinoma were retrospectively collected and analyzed. The tumor＇s location, size, form, signal, cystic wall, separation, nodule and degree of enhancement were described and recorded respectively. [Results] A mong 10 cases, there were 6 biliary cystadenomaes and 4 cystadenocarcinomaes. Lesions located at the left lobe in 8 cases and at the right lobe in 2 cases, multilocular room or cystic-solid tumors were found in 9 cases and a single room in 1. The liquid single was showed in cysty and the bloody fluid of 1 case showed high-signal intensity on TIWI/T2WI. 6 biliary cystadenomaes and 2 cystadenocarcinomaes showed regular and 2 cystadenocarcinomaes showed irregular. The cystic wall and separation showed slender and light-moderately delayed enhancement in 6 biliary cystadenomaes. The cystic wall, separation and nodule showed uneven and different degree delayed enhancement in 4 biliary cystadenocarcinomaes and showed obvious uneven enhance ment of 1 case. 10 tumores showed CK （AE1/AE3） and CK19 or didn＇t show AFP and CK20. [Conclusion] The hepatic biliary cystadenoma and cystadenocarcinoma can be diagnosed correctly according to the cystic fluid, cystic wall, separation and nodule of the MRI findings.

关 键 词：胆管肿瘤 囊腺瘤 囊腺癌 磁共振成像 病理学 

分 类 号：R735.8[医药卫生—肿瘤]