胆管癌的CT、MRI及MRCP诊断:附64例分析  

MRCP MRI and CT Diagnosis of Bile Duct Carcinoma: A Report of 64 Cases

作　　者：张荣[1] 宋莉[1] 付兵[1] 刘月皎[1] 陈攀[1] 

机构地区：[1]成都市第五人民医院放射科,四川成都611130

出　　处：《四川医学》2015年第11期1587-1590,共4页Sichuan Medical Journal

摘　　要：目的分析胆管癌的CT、MRI和MRCP表现,探讨对胆管癌的诊断价值。方法收集64例经手术病理证实的胆管癌,回顾性分析其CT、MRI及MRCP表现。结果肝内胆管癌12例,CT及MRI表现多有不规则片块影,相邻区域胆管扩张,增强扫描多为"延迟强化",DWI多见片团弥散减低区。肝门及肝外胆管癌52例,侵润狭窄型16例、肿块型26例,腔内生长型10例。CT平扫肝内胆管不同程度扩张,增强扫描胆管壁不均匀增厚,环形强化,管腔变窄,可见延迟强化结节,受阻平面以上扩张胆管显示多为"枯树枝状"、"软藤状"改变。MRI主要表现为肝内胆管扩张,肝门区病变主要表现为胆管突然截断、中断或充盈缺损,肝门部的软组织肿块,肝内胆管软藤样扩张;肝外胆管癌,MRCP可显示扩张的肝内外胆管及梗阻部位的狭窄、中断、截断和管腔内的充盈缺损。结论增强CT、MRI和MRCP联合应用能较好地对胆管癌进行较早期诊断,并能准确描述和评价胆管癌扩散及浸润范围。DWI多见病灶区弥散减低;MRI在病变良恶性鉴别上优于CT检查。Objective To investingate the diagnostic value of computed tomography（ CT）,magnetic resonance imaging（ MRI） and MRCPfor cholangiocarcinoma. Methods 64 cases of duct carcinoma comfimed by operation and pathology were collected,retrospectively analyzed clinical features by the CT、MRI and MRCP. Results in 12 cases of Intrahepatic bile duct carcinoma,CT and MRI showed multiple irregular piece of shadow,adjacent regions of bile duct dilatation,enhancement scanning for＂DWI＂,the delayed enhancement within the lesion seen film dispersion decreased areas. there were 52 cases with hilar and extrahepatic bile duct carcinoma,16 cases of stricture of biliary invasion type,block type in 26 cases,10 cases of intraductal growth type. CT plain scan and intrahepatic biliary duct dilation,enhanced thickening,non-uniform scanning bile duct lumen narrowing,visible nodules of delayed reinforcement,blocked bile duct above the level of multi display as＂withered branch shaped,＂＂Vine like＂change. Conclusion Enhanced CT、combined application of MRI and MRCPcan be better than the early diagnosis of bile duct carcinoma and can accurately describe and evaluate cholangio carcinoma proliferation and invasion range. DWI rare lesion dispersion decreased. MRI was superior in differential diagnosis of benign and malignant lesions on CT.

关 键 词：胆管癌 X线计算机体层成像 核磁共振成像 MRCP 

分 类 号：R735.8[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2