肝内胆管细胞癌17例CT误诊体会  

Misdiagnosis experience in 17 cases of intrahepatic cholangiocarcinoma CT

作　　者：何崇保 刘舒琼 黄财富 敬永国 

机构地区：[1]江油市中医医院放射科,四川江油621700

出　　处：《海南医学》2015年第16期2394-2396,共3页Hainan Medical Journal

摘　　要：目的探讨肝内胆管细胞癌的CT影像误诊原因,提高其诊断准确率。方法回顾性分析病理确诊为肝内胆管细胞癌且CT误诊的17例患者的影像资料,观察病变位置、形态、强化方式及伴随征象并联合临床表现及实验室检查结果进行分析。结果 9例误诊为肝细胞癌,3例误诊为胆总管囊肿或结石伴胆管扩张,3例误诊为肝脓肿,1例误诊为肝血管瘤,1例误诊为肝转移瘤。导致误诊的原因主要有:未做延迟扫描致病灶强化方式及特点不明确、影像诊断医师观察不仔细致遗漏一些关键影像表现、合并其他肝脏基础疾病致影像表现复杂等。结论肝内胆管细胞癌CT诊断误诊率较高,但其CT表现仍具有一定的特征性。Objective To investigate the reason of the misdiagnosis in the CT imaging ofintrahepatic chol- angiocarcinoma to improve the diagnostic accuracy. Methods Seventeen patients diagnozed as intrahepatic cholan- giocarcinoma by pathology and misdiagnosed by CT were retrospectively analyzed. The location, shape, strengthening manner and accompanied signs of lesion and joint clinical manifestations and laboratory test results were analyzed. Results Nine patients were misdiagnosed as hepatocellular carcinoma, and 3 were misdiagnosed as choledochal cyst or stone and bile duct dilation, with 3 as liver abscess, 1 as liver blood vessels aneurysm, and 1 as liver metastases. The main causes of misdiagnosis were as follows： unclear lesion enhancement and characters due to not performing delayed scan, negligence of radiologists, and complex imaging manifestations due to complication with other underly- ing diseases of liver. Conclusion The misdiagnosis rate of intrahepatic cholangiocarcinoma by CT is high, but the CT imaging performance still has certain characteristics.

关 键 词：电子计算机体层摄影 肝内胆管细胞癌 误诊 

分 类 号：R735.7[医药卫生—肿瘤]