肝门部胆管癌合并胆管结石的影像学特征分析  

Imaging features of hepatic hilar cholangiocarcinoma accompanied with bile duct stones

作　　者：曾焕忠[1] 毛家骥[2] 沈君[2] 

机构地区：[1]东莞市厚街医院放射科,东莞523945 [2]中山大学孙逸仙纪念医院放射科,广州510120

出　　处：《磁共振成像》2016年第10期763-768,共6页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的 探讨肝门部胆管癌合并胆管结石的影像学特点。材料与方法 收集经手术或活检病理证实的54例肝门部胆管癌,年龄28～86岁,中位年龄61岁,男34例,女20例,以MRI或CT上有无合并胆管结石分为两组,合并胆管结石11例（A组）,无胆管结石43例（B组）。回顾性分析并对比两组肿瘤大体分型、Bismuth-Corlette分型、肝叶萎缩及手术后复发情况。结果 54例肝门部胆管癌患者中,大体分型：A组浸润型3例（27.3%）、肿块型5例（45.4%）、息肉型3例（27.3%）;B组浸润型32例（74.4%）、肿块型8例（18.6%）、息肉型3例（7.0%）,两组肿瘤大体分型的差异有显著统计学意义（P〈0.05）。Bismuth-Corlette分型：A组I型2例（18.2%）、Ⅱ型1例（9.1%）、Ⅲa型4例（36.3%）、Ⅲb型2例（18.2%）、Ⅳ型2例（18.2%）;B组Ⅰ型3例（7.0%）、Ⅱ型14例（32.6%）、Ⅲa型6例（14.0%）、Ⅲb型10例（23.2%）、Ⅳ型10例（23.2%）,两组Bismuth-Corlette分型无统计学意义（P〉0.05）。术后复发：A组2例（18.2%）,B组8例（18.6%）;肝叶萎缩：A组4例（36.3%）,B组15例（34.9%）,两组术后复发及肝叶萎缩的差异均无统计学意义（P〉0.05）。结论 肝门部胆管癌合并胆管结石更多表现为肿块型和息肉型,肝门部胆管癌有无合并胆管结石在Bismuth-Corlette分型、肝叶萎缩及手术后复发情况上表现相似。Objective： To investigate cholangiocarcinoma with simultaneous the CT and MRI features of hepatic hilar bile duct stones. Materials and Methods： Fifty-four patients with hilar cholangiocarcinoma confirmed by surgical or biopsy pathology were enrolled. Thirty-four males and twenty females with ages between 28 and 86 years old （median age 61 years old）, All patients were divided into two groups according to the presence of absence of bile duct stones as detected by MRI or CT. Among 54 patients with hilar cholangiocarcinoma, eleven patients had bile duct stones （group A）, the remaining 43 cases had no bile duct stones （group B）. Tumor shape, Bisnauth-Corlette type, atrophy of liver lobe and postoperative rectlrrence were retrospectively analyzed and compared between the two groups. Results： For tumor shape, infiltrative type was found in 3 patients （27.3%） vs. 32 patients （74.4%）, mass type in 5 patients （45.4%） vs. 8 patients （18.6%）, polypoid type in 3 patients （27.3%） vs. 3 patients （7.0%） respectively in group A and group B. Significant difference was found in tumor shape between the two groups （P〈0.05）. As for Bisrnuth-Corlette type, there were 2 cases （18.2%） of type Ⅰ, 1 case （9.1%） of type Ⅱ, 4 cases （36.3%） of type Ⅲa, 2 cases （18.2%） of type Ⅲb, 2 cases （18.2%） of type Ⅳ in group A： and 3 cases （7.0%） of type Ⅰ, 14 cases （32.6%） of type Ⅱ, 6 cases （14.0%） of type Ⅲa, 10 cases （23.2%） of type Ⅲb, 10 cases （23.2%） of type Ⅳ in group B. No significant difference was found in Bismuth-Corlette type between the two groups （P〉0.05）. There were 2 recurrent cases （18.2%） in group A while 8 rectlnent cases （18.6%） in group B. There were 4 cases （36.3%） with liver lobe atrophy in group A and 15 cases （34.9%） with liver lobe atrophy in group B. No significant differences were found in postoperative recurrence and liver lobe atrophy between the two groups （P〉 0.05）. Conclusion： Hep

关 键 词：胆管肿瘤 胆结石 磁共振成像 体层摄影术 X线计算机 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.8[医药卫生—诊断学]