肝内胆管囊腺癌多层螺旋CT及磁共振成像诊断的影像学特征  

Characteristics of MSCT and MRI in the diagnosis of hepatobiliary cystadenocarcinoma

作　　者：吴珂[1] 薛鹏[1] 祁佩红[1] 马秀华[1] 陈勇[1] 张斯佳[1] 

机构地区：[1]郑州人民医院放射科,450003

出　　处：《中华肝胆外科杂志》2014年第4期245-247,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨多层螺旋CT（MSCT）及3．0T磁共振成像（MRI）对肝内胆管囊腺癌的诊断价值。方法回顾性分析我院经手术病理证实的8例肝内胆管囊腺癌影像学特征及临床资料，所有患者均做CT、MRI平扫及动态增强扫描。结果患者年龄48—74岁，中位年龄58岁；7例女性，1例男性。肿瘤位于左、右肝患者分别为5例、3例；1例多发，7例单发，均呈分房状。CT平扫表现为低密度及混杂密度，其中2例出血，3例见液平。MRI表现不同信号特征，囊液信号变化与囊内液体成分有关。囊壁内附着单个或多个乳头状结节，突向囊腔，T1WI壁结节呈略低信号，T2WI呈稍高信号，囊壁及分隔T1WI、T2WI均呈稍低信号，DWI显示壁结节呈明显高信号，囊液呈略高信号，囊壁及分隔呈低信号。CT、MRI动态增强扫描：动脉期壁结节明显强化，囊壁及囊内分隔轻微强化，门脉期及延迟期壁结节持续强化，囊壁及囊内分隔持续轻度延迟强化。结论肝内胆管囊腺癌的MSCT和MRI表现具有特征性。MSCT联合MRI是肝内胆管囊腺癌诊断及鉴别诊断的一种重要方法。Objective To study the characteristic findings of computer tomography （CT） and magnetic resonance imaging （MRI） in hepatobiliary cystadenocarcinoma. Methods CT, MRI and clinical data were analysed retrospectively. Plain, dynamic CT and MRI were performed in all patients. Results There were 8 patients, 7 female, 1 male, aged 48-74 years, with a median age of 58. Five lesions were in the left liver, and 3 lesions were in the right liver. One lesion was multilocular cysts with septations. Seven lesions were solitary. The lesions showed low or mixed density on plain CT. Two cysts showed evidence of hemorrhage, while 3 cysts showed fluid levels. There were different signal intensities in the cystic wall nodules which could appear as slightly low intensity on T1WI or slightly high intensities on T2WI. The cyst wall and septations appeared as slightly low intensity on T1WI and T2WI. The cystic fluid signal intensity changed with liquid ingredients. The nodularities showed obviously high signal intensity on DWI, and the fluid showed slightly high signal, while the cystic wall and separations showed slightly low signal intensity. On CT and MRI dynamic enhancement scanning, the nodularities showed obvious enhancement on the arterial phase, while the cystic wall and separations showed no enhancement. The nodularities showed persistent en- hancement on the portal venous and delayed phases while the cystic wall and separation showed slight en- hancement. Conclusions Hepatobiliary cystadenocarcinoma showed characteristic features on MSCT and MRI. MSCT combined with MR is an important method in the diagnosis and differential diagnosis of hepatobiliary cystadenocarcinoma.

关 键 词：胆管 囊腺癌 计算机断层成像 磁共振成像 扩散加权成像 

分 类 号：R735.8[医药卫生—肿瘤]