CT及MRI在黄色肉芽肿性胆囊炎诊断中的应用  

Clinical value of CT and MRI in diagnosis of xanthogranulomatous cholecystitis

作　　者：李代欣[1] 朱西琪[1] 田玉亭 孙晓东[1] 许传军[1] 丁怀银[1] 杜超[1] 

机构地区：[1]南京市第二医院放射科,江苏南京210003

出　　处：《生物医学工程与临床》2015年第2期164-168,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨CT及MRI对黄色肉芽肿性胆囊炎（XGC）的诊断价值。方法回顾性分析13例经手术病理证实的XGC患者,其中男性5例,女性8例;年龄54~76岁,平均年龄62.7岁。总结其CT和MRI表现。CT及MRI图像分析主要包括：胆囊壁的增厚情况及其强化方式、胆囊壁内结节、胆囊内壁黏膜线是否完整、胆囊内是否合并结石、胆囊周围有无渗出及邻近肝脏情况。术后病变组织送病理室行苏木精-伊红染色及免疫组织化学检测。结果 13例均有不同程度胆囊壁增厚,其中局限性增厚3例,弥漫性增厚10例。8例增厚的胆囊壁内可见多发壁内结节,T1WI呈等或稍低信号,T2WI呈高信号;9例表现为胆囊黏膜线完整;增强扫描5例可见＂夹心饼干征＂,7例邻近的肝实质内动脉期可见一过性强化。术后病理诊断XGC 13例,其中1例合并胆囊颈部腺癌。结论 CT及MRI诊断XGC具有一定的特征性,对XGC的诊断具有重要价值。Objective To investigate the diagnostic values of CT and MRI in patients with xanthogranulomatous cholecystitis（XGC）. Methods A total of 13 cases of XGC confirmed by surgical pathology were enrolled, which included 5 males and 8females, aged 54- 76 years old with mean age of 62.7 years old. The different imaging characteristics were observed and manifestations of CT and MRI were summarized. The image analysis of CT and MRI included the thickening and contrast enhancement of gallbladder wall, gallbladder wall nodules, completeness of gallbladder mucosa lines, gallbladder stones,exudation around gallbladder and adjacent liver parenchyma. The hematoxylin- eosin staining and immunohistochemistry were used for the lesions test. Results The gallbladder wall thickening was demonstrated in 13 cases, 3 of them were local thickening,10 were diffuse thickening. The multiple intramural nodules were presented in 8 cases, which existed low signal intensity on T1 WI and high signal intensity on T2 WI. The mucosal line was completed in 9 cases, which existed ＂hypodense band sign＂ by enhance scan in 5 cases, and transient enhancement of adjacent liver parenchyma in arterial phase was found in 7 cases. The 13 cases were confirmed XGC by pathological tissue, and 1 case combined with neck gallbladder adenocarcinoma. Conclusion It is demonstrated that XGC possesses the definite characteristic in CT and MRI findings, so the CT and MRI have important values in the diagnosis of XGC.

关 键 词：胆囊炎 黄色肉芽肿性 X线计算机体层摄影术(CT) 磁共振成像(MRI) 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.61[医药卫生—诊断学] R816.5[医药卫生—临床医学]