肝内周围型胆管细胞癌的CT表现  

CT features of intrahepatic peripheral cholangiocarcinoma

作　　者：叶红[1] 

机构地区：[1]广东省农垦中心医院放射科,广东湛江524000

出　　处：《海南医学》2015年第19期2871-2874,共4页Hainan Medical Journal

摘　　要：目的分析肝内周围型胆管细胞癌(IHPCC)的CT影像学特征及其与病理的相关性,提高对肝内胆管细胞癌CT诊断水平。方法回顾性分析我院2010年12月至2014年4月期间经手术或穿刺活检,病理证实的27例肝内周围型胆管细胞癌的CT表现,其中15例行穿刺组织活检,12例行手术治疗。结果 27例平扫呈低密度灶,边界不清。增强扫描动脉期有21例呈轻度强化;3例无强化,门脉期及延时期均逐渐向中心呈斑片、网格状强化;3例动脉期边缘明显环状强化,其中2例门脉期及延时期均逐渐向中心呈斑片、网格状强化,1例门脉期强化稍减退。结论肝内周围型胆管细胞癌的CT表现早期边缘轻度强化或不强化,延迟后逐渐向中心不均匀强化,但对强化不典型的病灶,应结合其间接征象和临床资料。Objective To analyze the CT imaging features of intrahepatic peripheral cholangiocarcinoma （IHPCC） and their correlation with pathological characteristics in order to improve the CT diagnostic level of intra-hepatic cholangiocarcinoma. Methods A retrospective analysis was made on CT images of 27 IHPCC patients in our hospital from December 2010 to April 2014. All these patients were confirmed by surgery or biopsy pathology of intrahepatic peripheral cholangiocarcinoma, 15 of whom underwent biopsy and 12 underwent surgical treatment. Results Plain scan showed low density foci and the boundary was not clear in all the 27 cases. In arterial phase en-hanced scan, 21 cases showed mild enhancement in arterial phase enhanced scan, and 3 cases showed no enhance-ment. Patches and reticular enhancement gradually appeared around the center in portal and delay phase. 3 cases showed margin distinctly enhanced in arterial phase, 2 cases of which showed gradually patches, reticular enhance-ment to the center in portal venous phase and delayed phase, and 1 case slightly decreased in portal vein phase. Conclusion Typical IHPCC lesion shows early edge mild enhancement or no enhancement, and inhomogeneous en-hancement gradually appears around the center in delay phase. To the atypical lesions, the diagnosis and differential di-agnosis of IHPCC should be made referring to the indirect signs and clinical data.

关 键 词：肝脏 周围型胆管细胞癌 体层摄影 鉴别诊断 

分 类 号：R735.7[医药卫生—肿瘤]