肝内胆管囊腺瘤的临床特征及CT影像特点  

The Clinical Features and CT Findings of Intrahepatic Calcified Biliary Cystadenoma

作　　者：桑玲[1] 母华国[1] 李冰城 刘超[1] 杨涛[1] 李丹[1] 陈伦刚[1] 徐霖[1] 

机构地区：[1]湖北省十堰市太和医院(湖北医药学院附属医院)医学影像中心,442000

出　　处：《临床放射学杂志》2016年第3期415-418,共4页Journal of Clinical Radiology

摘　　要：目的 探讨肝内胆管囊腺瘤（BCA）的临床特征及CT影像特点。方法 搜集本院手术病理证实的肝内BCA共9例,回顾性分析其临床、CT资料。结果 女4例,男5例,年龄52~78岁,平均66.8岁,病程3~6年,平均4.6年,7例无任何症状,另2例仅表现为右上腹隐痛不适,患者均无发热,无肝炎、肝硬化,无其他恶性肿瘤病史,实验室检查CEA、AFP、CA125均正常。9例均单发,共9个病灶,肝左叶3例,右叶6例。CT平扫均表现低密度、多房、囊性肿块,境界清楚,分叶状,内见多发大小不等的囊腔,呈均匀水样密度,囊内均见纤细分隔,粗细均匀,厚约2~3 mm,CT值21~27 HU,囊壁及分隔均见钙化,其中细小斑点状钙化4例,结节状钙化3例,斑点状及结节状钙化2例,直径均≤5 mm,增强动脉期囊壁及分隔轻度强化,CT值31~42 HU,门脉期中度强化,CT值51~61HU,延迟期持续强化,CT值62~69 HU。肿块内均无壁结节或乳头状突起,周围及肝内胆管均无扩张、结石。结论肝内BCA虽罕见,但具有一定特点,病程长,进展缓慢,且多无症状或症状轻微,实验室检查指标CEA、AFP、CA125正常,CT表现为肝内单发、多房、囊性分叶状肿块,囊腔大小不一,呈均匀水样密度,囊壁及分隔纤细、粗细均匀,并见细小斑点状、结节状钙化,无壁结节或乳头状突起,增强囊壁及分隔呈持续性、渐进性强化,囊液始终无强化。Objective To investigate the clinical features and CT image findings of the intrahepatic biliary cystadenoma （BCA）. Methods The clinical imformation and CT image of 9 cases of intrahepatic BCA; proved by surgery and pathology; were collected and analyzed retrospectively. Results These 9 cases are consisted of 4 females and 5 males, aging from 52 to 78 year old ,whose average age is 66.8 year old. The course of disease lasts 3 to 6 years ,average 4.6 years. Of all 9 cases ,7 of them had no symptoms, another 2 cases just showed right epigastric discomfort. All patients had no fever, hepatitis ,liver cirrhosis and malignancy, laboratory examinations of CEA ,AFP, CA125 were normal. All 9 cases are all of a single lesion,3 of which were located in the left lobe and another 6 cases in the right lobe. All the lesions were lobulated, hypodense, cystic masses with clear boundaries and multiple cavities of variant size inside. These lesions are of uniform wa- ter density with septations of uniform thickness; about 2-3 mm;whose CT value ranges from 21 to 27 HU. Calcification can be seen in both sac wall and septations. We noticed fine punctate calcification in 4 cases, nodular calcification in 3 cases and patchy and nodular calcification in 2 cases. The diameter of all calcification are less than or equal to 5mm. Mild enhancement for cystic wall and septum in the arterial phase in CECT, with CT value ranging from 31 to 42 HU, moderate enhancement in portal vein phase with CT value ranging from 51 to 62 HU and continuous enhancement in delayed phases with CT value ranging from 62 to 69 HU. There were no wall nodules and papillary projections inside the tumor and no dila- tation or calculi in the surrounding and intrahepatic bile ducts. Conclusion Although intrahepatie BCA are rare,but have certain characteristics, and there is a longer course, slow progression, and no or mild symptoms. The laboratory examination of CEA, AFP, and CA125 were normal. CT showed single muhilocular cystic mass with multiple sizes of cavity ins

关 键 词：胆管肿瘤 囊腺瘤 体层摄影术 X线计算机 

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