肝内胆管囊腺瘤及囊腺癌的螺旋CT表现与病理对照  

Intrahepatic biliary cystadenoma and cystadenocarcinoma:comparison analysis of CT features and pathologic findings

作　　者：宋斌[1,2] 刘燕[1] 屠文刚[3] 王丽[3] 张扬[3] 时倩倩[3] 陈晓炎[4] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]瑞金医院 [3]安徽省阜阳市人民医院CT/MRI室,安徽阜阳236000 [4]上海交通大学医学院附属瑞金医院病理科,上海200025

出　　处：《诊断学理论与实践》2014年第2期198-201,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:对照分析肝内胆管囊腺瘤及囊腺癌的螺旋CT表现与病理结果,旨在提高其影像诊断水平。方法:回顾性分析8例肝内胆管囊腺瘤及囊腺癌病例的病理资料及螺旋CT表现,其中囊腺癌3例,囊腺瘤5例,所有病例均经手术病理证实。8例均行CT平扫及动脉期、门静脉、延时期三期增强扫描。结果:8例患者的病灶均呈薄壁囊性肿物,圆形、类圆形分叶状或趋于分叶状,外缘光滑7例,1例伴发感染而外缘模糊。3例囊腺癌中,囊内出血1例,囊液密度均匀2例;多房伴分隔2例;伴细小囊壁钙化1例,粗大壁结节3例。5例囊腺瘤中,多囊伴分隔4例,分隔菲薄均匀;囊液密度均匀5例;伴细小壁结节3例;增强后病灶囊壁、分隔及壁结节均呈持续强化改变。病理上,大体所见与影像学所见相似,为类圆形、边界清楚囊性病灶;镜下,囊壁内衬单层上皮,上皮下为致密纤细的梭形间质细胞增生,肿瘤间质血管较少。结论:肝内胆管囊腺瘤及囊腺癌的螺旋CT表现具有一定特征性,CT平扫和动态增强能较好地反映其病理学特点,有助于该疾病的诊断。Objective： To compare CT features and pathologic findings of intrahepatic biliary cystadenoma and cystadenocarcinoma for improving the diagnosis by CT imaging. Methods： Three cases of cystadenocarcinoma and 5 cases of cystadenoma were enrolled. All of the cases were pathologically confirmed and had undergone CT plain and three phase enhancement scanning. Result： All these cases showed round cystic lesion with welldefined border. In the 3 cases of cystadenocarcinoma, 1 case showed intracystic hemorrhage; 2 cases with homogeneous density; 2 cases manifested muhiroom with septa; 1 case showed calcifications of capsule wall; 3 cases showed gross nodule on the capsule wall. Of the 5 cases of cystadenoma, cystic fluid displayed homogeneous fluid attenuation; 2 cases had small nodules. After injection of contrast medium, cyst wall and nodules showed continued enhancement. CT findings were similar to that of gross pathology specimen, with a round and clear boundary cystic lesion. Under microscopy, wall of the cyst was lined with a single layer of epithelium. The subepithelial layer showed dense slender spindle stromal cell, with fewer vessels in tumor interstitium. Conclusions： MSCT findings of intrahepatic biliary cystadenoma and cystadenocarcinoma have certain characteristics; CT scan and dynamic enhancement can reflect its pathological features, which will be useful for diagnosis.

关 键 词：胆管 囊腺瘤 囊腺癌 X线计算机 

分 类 号：R445.4[医药卫生—影像医学与核医学]