肝脏胆管内乳头状黏液性癌的磁共振表现分析  

Analysis of magnetic resonance imaging features of intraductal papillary mucinous carcinoma of the liver

作　　者：李滨[1] 金延方[1] 刘洪亮[1] 马中宁 杜雪梅[2] 李昕[3] 

机构地区：[1]首都医科大学附属北京世纪坛医院MR室,北京100038 [2]首都医科大学附属北京世纪坛医院病理科,北京100038 [3]吉林大学第二医院放射线科,吉林长春130022

出　　处：《中国医刊》2017年第5期65-69,共5页Chinese Journal of Medicine

摘　　要：目的探讨磁共振(magnetic resonance,MR)诊断肝脏胆管内乳头状黏液性癌(intrabiliary papillary mucinous carcinoma of liver,IPMC-L)的临床价值。方法回顾性分析本院2014年10月至2016年10月收治的5例经病理证实并行MR检查的IPMC-L患者的临床资料,对肿瘤的发病部位、形态、生长方式、MR信号及强化特点进行分析。结果发病部位:肝顶1例,肝脏左叶4例。MR表现:肿瘤实体呈结节样或菜花样改变,沿扩张胆管内壁生长,T_1W序列呈稍低信号,T_2W序列呈稍高信号,在动态扫描各期均呈持续性较低水平增强,其内可见小囊泡样无强化黏液积聚区。在黏液背景的衬托下,实性瘤体与扩张胆管相通是其特征性改变。结论 IPMC-L的MR表现具有一定特点,以实性瘤体与扩张胆管相通的MR表现为著,可为IPMC-L的诊断及鉴别诊断提供帮助。Objective To investigate the value of magnetic resonance （MR） diagnosis in intrabiliary papillary mucinous carcinoma of liver （IPMC-L）. Method 5 cases proved by pathology were collected and analyzed retrospectively, in our hospital from 2014 Oct to 2016 Oct. All cases were performed with MR. The MR findings including location, shape, growth type, MR findings were analyzed. Result 1. Location： one case was laid in the top of liver, 4 cases were laid in left hepatic lobe. MR findings can be summarized as follows： The appearance of tumor were nodular-like or cauliflower-like shapes. The solid parts of IPMC-L were growed along the abnormal dilatation of the intrabiliary wall and communicated with the dilated bile duct, in T1W sequence the tumor＇ signal intensity was simple lower. In T2W sequence the tumor＇ signal was simply higher. In enhanced MR sequence The tumor showed slightly low and still enhancement, in which there were non- enhancement-little-vesicles. The most characteristic MR findings was the communication between tumor and dilated bile duct. Conclusion MR findings of IPMC-L had certain characteristics, obvious is the communication between tumor and dilated bile duct against mucus. MR could be helpful for the diagnosis and differential diagnosis in IPMC-L.

关 键 词：肝脏 胆管内乳头状黏液性癌 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤]