黄色肉芽肿性胆囊炎的MRI表现(附7例报道)  

MRI Appearances of Xanthogranulomatous Cholecystitis in 7 Patients

作　　者：苟文枭 印隆林[2] 谢欢[1,2] 陈小煜 王富民[2] 

机构地区：[1]西南医科大学医学影像系,四川泸州646000 [2]四川省医学科学院.四川省人民医院放射科,四川成都610072

出　　处：《中国普外基础与临床杂志》2016年第3期355-359,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨MRI诊断黄色肉芽肿性胆囊炎(XGC)的临床价值,同时分析其影像学表现的病理学基础。方法回顾性分析2013年1月至2015年11月期间在四川省人民医院行上腹部MRI检查且经术后病理学检查证实为XGC的7例患者的MRI图像资料。所有患者均接受了完整的MRI序列检查。每例患者重点观察胆囊壁增厚及强化情况、胆囊壁内结节、胆囊黏膜线是否完整、胆囊结石、胆囊周围组织改变等情况。结果 7例XGC患者的胆囊壁均增厚,其中2例呈局限性增厚,5例呈弥漫性增厚;4例见典型的"夹心饼干征";6例胆囊黏膜线连续,1例不连续;5例胆囊壁内见结节影,在T1WI图像上呈低信号,在T2WI图像上呈高信号;6例并发胆囊结石;7例见胆囊周围脂肪间隙模糊、肝实质与胆囊分界不清;增强扫描时所有病例均出现动脉期胆囊周围肝实质斑片状一过性强化,1例并发肝脓肿;2例肝门部胆管狭窄、肝内胆管扩张,2例(1例伴有胆总管下端结石)肝内外胆管均轻度扩张;3例伴发肝囊肿,4例见单或双肾囊肿;7例均未发现腹腔内及腹膜后肿大淋巴结。结论 MRI检查可以准确描述XGC的各种影像学特征,对XGC的诊断具有重要价值。Objective To investigate clinical value of MRI examination in diagnosis of xanthogranulomatous cholecystitis（XGC）, and to analyze pathologic correlation of various imaging findings. Methods MRI imaging data of 7 patients with XGC proved by surgery and pathology who underwent entire MRI sequences examination in Sichuan Provincial People’s Hospital from Jan. 2013 to Dec. 2015, were analyzed retrospectively. The thickness and contrast enhancement of gallbladder wall, gallbladder wall nodules, completeness of gallbladder mucosa lines, gallbladder stones, and the changes around the gallbladder were focused in every patient. Results In 7 patients with XGC： gallbladder wall thickening occurred in all patients, in which 2 patients were local thickening, 5 patients were diffuse thickening; ‘hypodense band sign’ was found by enhance scan in 4 patients; the multiple intramural nodules were presented in 5 patients, which were low signal intensity on T1 WI image and high signal intensity on T2 WI image; the mucosal lines were continuous in 6 patients and discontinuous in 1 patient; 6 patients combined with cholecystolithiasis. The fat layer around the gallbladder was found fuzz in 7 patients, liver and gallbladder boundaries were not clear in 7 patients; temporal enhancement of arterial phase in liver parenchyma was observed in all patients, and 1 patient combined with liver abscess. Hilar bile duct narrowed and intra-hepatic bile duct dilated in 2 patients, intra-hepatic and extra-hepatic bile duct slightly dilated in 2 patients（lower part of the choledochus stone was found in 1 patient）, liver cyst was observed in 3 patients, single or double kidney cyst was observed in 4 patients; all patients were not found intraperitoneal or retroperitoneal swelling lymph nodes. Conclusion MRI examination can accurately describe various imaging features of XGC, so MRI has important value in diagnosis of XGC.

关 键 词：黄色肉芽肿性胆囊炎 核磁共振成像 价值 

分 类 号：R575.61[医药卫生—消化系统] R445.2[医药卫生—内科学]