胆管错构瘤的影像学表现  

Imaging features of biliary hamartomas

作　　者：魏巍巍[1] 甘洁[1] 王振松[1] 刘建宪[1] 

机构地区：[1]山东中医药大学第二附院放射科,山东济南250001

出　　处：《医学影像学杂志》2017年第2期270-272,276,共4页Journal of Medical Imaging

摘　　要：目的探讨胆管错构瘤的超声、CT及MRI影像学表现,并比较三种影像学检查方法对其诊断的价值。方法回顾性分析12例胆管错构瘤的超声、CT及MRI表现及相关临床资料,并与病理结果对照。结果超声检查胆管错构瘤表现为肝实质非均匀性回声增强,可见"彗星尾征"及"等号征";CT平扫表现为点状低密度灶弥漫或局限性分布,增强扫描5例未见增强,3例部分病灶边缘轻度强化。MRI检查T_1WI呈低信号,T_2WI呈高信号,重T_2WI呈更高信号,增强扫描7例可见环形强化。结论超声及CT检查对胆管错构瘤的准确诊断不及MRI敏感、可靠,通过超声检查出可疑的胆管错构瘤,首选的进一步影像学诊断方法是MRI。但超声检查简便易行,经济廉价,因此,是本病检出与随访过程中的重要而首选的检查方法。Objective This study is to compare the value of ultrasonography, computed tomography （CT） and magnetic reso- nance imaging （MRI） in the diagnosis of biliary hamartomas. Methods 12 cases of liver biopsies were found to have biliary hamartomas. Imaging features （including ultrasonography, CT and MRI） of those cases were analyzed and summarized retrospec- tively. Comparison was made between the resuh of imaging and pathology. Results According to ultrasound images, the areas with biliary hamarto,nas were heterogeneous and slightly hyperechoic. All cases had numerous tiny hypo-or hyperechoic lesions with comet-tail echoes and ＂equal＂ sign. On plain CT, biliary hamartomas were presented as multiple hypodense lesions. After intravenous injection of contrast medium, 5 cases showed no enhancement and 3 cases showed thin rim-like enhancement in the delayed phase. Biliary hamartomas were presented as hypo-intense on T1 -weighted images and hyperintense on T2-weighted ima- ges. On ＂heavily＂ TE-weighted sequences, the signal intensity of the lesions was enhanced. Gadolinium-enhanced images showed peripheral rim-like enhancement （ Fig. 3B） in 7 patients but no enhancement in the other 5 patients. Conclusion Biliary hamar- tomas showed characteristic features on imaging findings by uhrasonography, CT, and MRI. Although abdominal ultrasonography could detect suspected biliary hamartomas, the best choice for further diagnosis is MRI and ultrasonography can be used in follow- ing-up examination.

关 键 词：胆管错构瘤 超声诊断 体层摄影术 X线计算机 磁共振成像 

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