嗜酸性胆囊炎的临床病理和CT及MRI分析  

The clinicopathology and CT and MRI features of eosinophilic cholecystitis

作　　者：王凌[1] 李职跃 WANG Ling;LI Zhiyue(Department of Radiology,General Hospital of Chongqing Iron and Steel Group,Chongqing 400081,China;Department of Radiology,the Central Hospital of Jiangjin,Chongqing 400080,China)

机构地区：[1]重庆市重钢总医院放射科,重庆400081 [2]重庆市江津区中心医院放射科,重庆400080

出　　处：《实用放射学杂志》2018年第9期1393-1396,1442,共5页Journal of Practical Radiology

摘　　要：目的 初步探讨嗜酸性胆囊炎（EC）的临床特点、病理和CT及MRI表现。方法 回顾性分析10例经病理证实为EC患者的临床症状、外周血嗜酸性粒细胞及病理等相关资料，并对EC的CT及MRI表现与病理特点作对照分析。结果 在临床上，所有患者均表现为急性胆囊炎症状，以右上腹痛为主，4例患者出现外周血嗜酸性粒细胞增高；在病理上，EC组织较密实，表现为大量嗜酸性粒细胞在胆囊壁呈局灶性或弥漫性浸润，伴有纤维组织增生；在影像上，3例表现为局限性宽基底胆囊肿块，2例表现为胆囊壁局限性增厚，5例表现为胆囊壁弥漫性增厚， CT呈等或低密度，T1WI呈等或低信号，T2WI/T2WI脂肪抑制呈低信号，扩散加权成像（DWI）呈扩散受限， CT及MRI增强扫描病灶均随时间延迟呈渐进性强化。结论 EC具有典型的临床特点和CT及MRI表现，其影像表现与病理学基础密切相关。Objective To preliminarily investigate the clinical and pathological characteristics, and CT and MRI performance of eosinophilic cholecystitis （EC）.Methods The clinical symptoms, peripheral blood eosinophils and pathological data in 10 patients with EC confirmed by pathology were analyzed retrospectively,the CT and MRI findings were compared with the pathological features. Results All the patients presented with acute choleeystitis symptoms, mainly exhibiting right upper abdominal pain.Increased eosinophils in peripheral blood was shown in 4 patients.The pathological results showed dense tissue of EC with a large number of eosinophils in gallbladder wall with focal or diffuse infiltration accompanying with fibrous tissue hyperplasia.CT and MRI showed localized gallbladder mass with broad base in 3 cases,localized thickening of gallbladder wall in 2 cases and diffuse thickening of gallbladder wall in 5 cases. The lesions demonstrated isodensity or hypodensity on CT. On MRI, the lesions demonstrated isointensity or hypointensity on T1 weighted imaging and hypointensity on T2 weighted imaging.Diffusion weighted imaging showed the lesions with hyperintensity.Enhanced CT and MRI showed the lesions with progressive enhancement with time delay. Conclusion EC have typical clinical features and CT and MRI manifestations, and its imaging findings are closely related to the pathological features.

关 键 词：胆囊炎 嗜酸性粒细胞 计算机体层成像 磁共振成像 病理学 

分 类 号：R575.61[医药卫生—消化系统] R814.42[医药卫生—内科学]