CT 及 MRI 对肝内周围型胆管癌综合诊断研究  

CT and MRI in the comprehensive diagnosis of intrahepatic peripheral cholangiocarcinoma

作　　者：秦斌[1] 袁翠平[1] 林有丹 祝新[1] 

机构地区：[1]南京中医药大学附属医院放射科,江苏 南京210029

出　　处：《实用放射学杂志》2015年第10期1624-1627,共4页Journal of Practical Radiology

摘　　要：目的：探讨 CT 及 MRI 检查对肝内周围型胆管癌（IHPCC）的诊断价值。方法回顾性收集并分析 IHPCC 32例,25例行 CT 平扫及增强扫描,18例行 MRI 平扫和 MRCP 扫描（8例行 MRI 动态增强扫描）,其中6例同时做过 CT 和 MRI 平扫和增强检查。结果共收集肝内病灶32个,CT 和 MRI 均可显示全部病灶。CT 病灶表现为等低密度,T1 WI 表现为稍低或等信号,T2 WI为不均匀稍高信号。增强扫描动脉期18例病灶外周部分呈轻度线状强化,3例外周明显强化,11例未见强化；门脉期、静脉期和延迟扫描19例病灶呈渐进性轻中度不均匀强化,6例均匀强化,有明显延迟强化特征者25例。MRCP 能清晰显示肝内外胆管形态。其他征象有肝内胆管扩张23例,肝内胆管结石6例,肝叶萎缩15例,肝包膜局部凹陷8例。结论CT 和 MRI 均是 IHPCC 的有效检查方法。MRI 在显示肿瘤大小和边界、胆管壁受累、扩张程度和门静脉侵犯等方面较 CT 更有优势。CT 和 MRI 结合对于 IHPCC 的诊断更具价值。Objective To analyze the value of CT and MRI in the diagnosis of intrahepatic peripheral cholangiocarcinoma （IHPCC ）. Methods 32 cases of intrahepatic peripheral cholangiocarcinoma were collected and analyzed retrospectively.25 patients underwent plain and enhanced CT scan,while 18 cases underwent plain MRI and MRCP（8 of them underwent MRI dynamic enhancement scanning）.6 cases underwent plain and enhanced scan of CT and MRI simultaneously.Results 32 intrahepatic lesions were found,with CT and MRI revealing all lesions.Lesions of IHPCC showed as hypo-or iso-density on the plain CT,slightly hypo-intensity on T1 WI and uneven mild hyper-intensity on T2 WI.During arterial phase of contrast-enhanced scan,18 lesions showed as marginal mild linear enhancement,3 cases with obvious enhancement and 11 cases with no enhancement.During portal phase,venous phase and delayed scan,19 lesions showed as progressive mild-to-mod-erate uneven enhancement,while 6 cases enhanced homogeneously.25 cases showed characteristic significantly delayed enhance-ment.MRCP could display satisfactory of Intra-and-Extra-hepatic bile ducts.Other signs include intrahepatic bile ducts dilation （23 cases）,intrahepatic bile duct stones （6 cases）,hepatic lobe atrophy （1 5 cases）,and depressed liver capsula （8 cases）.Conclusion Both CT and MRI are effective methods for diagnosing of intrahepatic peripheral cholangiocarcinoma.Compared with CT,MRI seems more valuable on presentation the tumor size and border,bile duct involvement,the degree of expansion and portal vein inva-sion,etc.It is more valuable to combine CT with MRI for the diagnosis of intrahepatic peripheral cholangiocarcinoma.

关 键 词：肝脏 胆管细胞癌 计算机体层成像 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤] R814.42[医药卫生—临床医学]