周围型肝内胆管细胞癌CT误诊分析  

CT misdiagnosis analysis of peripheral intrahepatic cholangiocarcinoma

作　　者：何瑜[1] 孙凤[1] 王晋秋[1] 

机构地区：[1]四川省绵阳市中心医院放射科,四川绵阳621000

出　　处：《实用医院临床杂志》2016年第5期96-98,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨周围型肝内胆管细胞癌(PICC)的多层螺旋CT误诊原因,总结其影像学特征及鉴别诊断要点。方法回顾性分析经病理确诊为周围型肝内胆管细胞癌且术前CT误诊的32例患者资料,观察病变形态、位置、影像学特征,总结CT误诊原因。结果 32例误诊患者中,12例误诊为肝细胞肝癌,9例误诊为肝脓肿,6例误诊为胆管结石或胆管炎伴扩张,4例误诊为肝乏血性海绵状血管瘤,1例误诊为转移瘤。误诊的原因主要有病变本身病理、血供特点不典型,扫描期相不准确或未做延迟扫描致病变强化特点欠明确,合并其他肝脏病变致影像表现复杂,影像诊断医师诊断草率、观察不仔细遗漏一些细节特点等。结论周围型肝内胆管细胞癌不典型病例较多,适时延迟扫描可发现一定的特征,是诊断PICC的有效方法。Objective To investigate the reason of misdiagnosis by MSCT imaging for peripheral intrahepatic eholangiocarcinoma （PICC） and summarize the imaging features and differential diagnosis. Methods Data of 32 PICC patients were retrospectively an- alyzed. These patients were misdiagnosed by CT before operation but confirmed by pathology. The lesion morphology,location and image features were analyzed to explore the reasons of misdiagnosis of CT. Results Of these patients, 12 patients were misdiagnosed as hepa- tocellular carcinoma,9 as liver abscess,6 as bile duct stone or cholangitis accompanying dilation,4 as liver cavernous hemangioma and 1 as liver metastases. The main causes of misdiagnosis included the pathology and blood supply of the lesions were atypical, the en- hancement characters of the lesions were unclear due to not performing delayed scan, the complex imaging findings due to complication with other primary diseases of liver, and some key imaging features were missed by radiologists because negligence Observing. Conclu- sion Atypical cases of PICC occupied a large proportion. Some imaging features can be found in timely delayed scan, which is an effective method for diagnosis PICC and improves the diagnostic accuracy before operation.

关 键 词：胆管细胞癌 误诊分析 体层摄影 X射线计算机 

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