动态增强CT扫描对肝内胆管囊腺癌的诊断价值  

Diagnostic Value of Dynamic Enhanced CT Scan for Intrahepatic Bile Duct Cystadenocarcinoma

作　　者：孟祥云 武艳 刘波 MENG Xiang-yun;WU Yan;LIU Bo(Department of Radiology,People's Hospital of Pingyi County,Pingyi,Shandong Province,273300 China;Department of Ultrasonography,Pingyi County Psychological Hospital,Pingyi,Shandong Province,273300 China)

机构地区：[1]平邑县人民医院放射科,山东平邑273300 [2]平邑县心理医院B超室,山东平邑273300

出　　处：《世界复合医学》2020年第3期10-12,共3页World Journal of Complex Medicine

摘　　要：目的探讨增强CT扫描肝内胆管囊腺癌的影像学特点及定性诊断价值。方法回顾性分析2011年1月—2019年4月平邑县人民医院41例经手术病理证实的肝内胆管囊腺癌影像学特点,并分析增强CT对肝内胆管囊腺癌的诊断率。结果①41例肝内胆管囊腺癌手术标本右半肝31例,左半肝10例,肿瘤平均直径为(5.9±1.6)cm,圆形或者类圆形,单囊性38例,多囊性3例,囊壁结节样凸起或块状凸起,囊内有黄色、白色或棕色粘稠液体。②CT平扫肿瘤表现为圆形或类圆形低密度影,边界较清晰;3例可见囊内分隔;24例可见囊壁凸起结节或团块。③增强扫描动脉期囊壁及结节均可见强化,囊壁及结节CT值高于平扫期(t=6.142,P<0.001),门脉期可见进一步强化,囊壁及结节CT值高于动脉期(t=7.012,P=0.000),延迟期仍可见增强,囊壁及结节CT值同低于门脉期(t=4.923,P=0.003),④平扫CT诊断囊腺癌16例(39.0%),增强CT诊断囊腺癌40例(97.5%),增强CT扫描诊断率高于平扫CT(χ2=15.719,P=0.000)。结论肝内胆管囊腺癌增强CT扫描具有特征性的影像学特点,增强CT扫描能够肝内胆管囊腺癌的定性诊断提供依据。Objective To investigate the imaging characteristics and qualitative diagnostic value of intrahepatic bile duct cystadenocarcinoma by enhanced CT scan.Methods A retrospective analysis was performed on the imaging characteristics of 41 cases of intrahepatic bile duct cystadenocarcinoma confirmed by surgery and pathology in Pingyi County People's Hospital from January 2011 to April 2019,and the diagnosis rate of intrahepatic bile duct cystadenocarcinoma was analyzed by enhanced CT.Results 1.41 cases of intrahepatic bile duct cystadenocarcinoma were treated with 31 cases of right hepatic liver and 10 cases of left hepatic liver.The average tumor diameter was(5.9±1.6)cm,round or quasi-circular,38 cases were monocystic,3 cases were polycystic,nodular or lumpy protrusions of the capsule wall,yellow,white or brown viscous liquid inside the capsule.2.CT plain scan tumors showed round or circular low-density shadows with clear borders;3 cases showed intracapsular separation;24 cases showed raised nodules or clumps in the capsule wall.3.The cyst wall and nodules were enhanced during the arterial scan.CT values of the cyst wall and nodules were higher than those of the plain scan(t=6.142,P<0.001),and further enhanced during the portal phase.CT values of the cyst wall and nodules were higher than In the arterial phase(t=7.012,P=0.000),the delay phase can still be seen to increase.CT values of the cyst wall and nodules are also lower than those in the portal phase(t=4.923,P=0.003).4.Plain scan CT diagnosis of cystadenocarcinoma 16 cases(39.0%),40 cases(97.5%)of cystadenocarcinoma diagnosed by enhanced CT,and the diagnosis rate of enhanced CT scan was higher than that of plain CT(χ2=15.719,P=0.000).Conclusion Enhanced CT scan of intrahepatic bile duct cystadenocarcinoma has characteristic imaging characteristics.Enhanced CT scan can provide a basis for the qualitative diagnosis of intrahepatic bile duct cystadenocarcinoma.

关 键 词：增强CT 肝内胆管囊腺癌 囊壁强化 肝脏 胆管 

分 类 号：R735[医药卫生—肿瘤]