肝内胆管错构瘤的影像学诊断  

Imaging diagnosis of intrahepatic biliary hamartomas

作　　者：朱艳艳 孙英姿 杨丽 马祥兴[3] 侯代伦 ZHU Yanyan;SUN Yingzi;YANG Li;MA Xiangxing;HOU Dailun(Department of Radiology, Shandong Provincial Third Hospital, Jinan 250031, P.R.China;Department of Ultrasonography, Shandong Provincial Third Hospital, Jinan 250031, P.R.China;Department of Radiology, Qilu Hospital, Shandong University, Jinan 250012, P.R.China;Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing 101149, P.R.China)

机构地区：[1]山东省立第三医院影像中心,山东济南250031 [2]山东省立第三医院超声科,山东济南250031 [3]山东大学齐鲁医院放射科,山东济南250012 [4]首都医科大学附属北京胸科医院影像科,北京101149

出　　处：《医学影像学杂志》2020年第12期2254-2257,共4页Journal of Medical Imaging

摘　　要：目的探讨肝内胆管错构瘤的超声、CT及MRI影像学表现,并比较三种影像学检查方法对该病的诊断价值,提高对该病的认识。方法选取我院确诊的13例成人肝脏胆管错构瘤作为研究对象,分析其超声、CT及MRI表现。结果病变弥漫分布于全肝者10例,不均分布在肝左、右叶者3例;形态多样,呈菱形、卵圆形、圆形或不规则形,直径1~10 mm,多数病变边界不清。超声表现为肝实质非均匀性回声增强,可见“等号征”及“蝌蚪征”;CT平扫表现为不规则或椭圆形的低密度病灶,增强扫描未见强化;MRI平扫病变呈稍长或长T1,稍长或长T2信号,增强扫描2例可见边缘轻度环形强化;MRCP表现为弥漫分布的病灶沿胆管走行、不与胆管相通。结论超声及CT检查对胆管错构瘤的诊断准确性不及MRI,通过超声或CT检查出可疑的胆管错构瘤,需进一步采用MRI予以证实。Objective To investigate the imaging manifestations of intrahepatic biliary hamartomas by ultrasonography,CT and MRI,and to compare the diagnostic value of three imaging methods,so as to improve the understanding of this disease.Methods 13 cases of intrahepatic biliary hamartomas diagnosed in our hospital were selected,and their imaging manifestations were analyzed.Results In 10 cases,the lesions were diffusely distributed in the liver,and in 3 cases,the lesions were unevenly distributed in the left or right lobes of the liver.The morphology of lesions was various,including diamond,oval,round and irregular,with a diameter of 1~10 mm.The boundary of most lesions was indistinct.The ultrasonography showed inhomogeneous echo enhancement of liver parenchyma,which showed“equal sign”and“tadpole sign”;CT showed irregular or oval low-density lesions,and no enhancement by contrast-enhanced scan.The lesions were low signal on T1WI and high signal on T2WI.Gadolinium-enhanced images showed peripheral rim-like enhancement in 2 patients.MRCP showed that the lesions were along the bile duct and not connected with the bile duct.Conclusion The accuracy of ultrasonography and CT was not as good as MRI in the diagnosis of intrahepatic biliary hamartoma.

关 键 词：胆管错构瘤 超声检查 体层摄影术 X线计算机 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]