胆囊腺肌增生症的影像学特征及诊断  

Imaging features and diagnosis of gallbladder adenomyosis

作　　者：潘永军 刘铁军[1] 颜俏燕[1] 韩秋丽[1] 刘有利 PAN Yongjun;LIU Tiejun;YAN Qiaoyan;HAN Qiuli;LIU Youli(Department of Radiology,Liuzhou People′s Hospital,Liuzhou,Guangxi 545006,China;Department of Pathology,Liuzhou People′s Hospital,Liuzhou,Guangxi 545006,China)

机构地区：[1]广西壮族自治区柳州市人民医院放射科,545006 [2]广西壮族自治区柳州市人民医院病理科,545006

出　　处：《重庆医学》2021年第19期3360-3364,共5页Chongqing medicine

摘　　要：目的分析胆囊腺肌增生症(GBA)的影像学特征及其诊断价值,提高对其诊断的准确性。方法收集2014年12月至2019年5月在该院经过手术并有病理证实的34例GBA患者的影像学检查资料,分析其影像学特征。结果局限型GBA动脉期主要表现为病灶轻度至中度均匀强化,门静脉及延迟期病灶呈渐进性均匀强化,节段型及弥漫型GBA动脉期表现为病灶黏膜及黏膜下强化,门静脉期及延迟期病灶强化逐渐向肌层及浆膜层延展。局限型GBA均呈乳头状改变,节段型多可见典型“束腰征”,少数呈体底部节段性增厚,弥漫型均可见典型“花环征”。MRI对GBA的罗-阿氏窦(RAS)诊断准确率明显高于CT。结论GBA具有特征性影像表现,认识其影像学特征有利于提高术前诊断的准确性。Objective To analyze the imaging features and diagnostic value of gallbladder adenomyosis(GBA)and improve its diagnostic accuracy.Methods From December 2014 to May 2019,the imaging data of GBA in 34 patients who had undergone surgery and confirmed by pathology were collected.Then the imaging characteristics were analyzed.Results The arterial phase of limited type GBA was mainly manifested as mild to moderate homogeneous enhancement of the lesion.The portal vein and delayed phase lesions presented progressive homogeneous enhancement.The arterial phase of segmental and diffuse type GBA was manifested as mucosal and submucosal enhancement of the lesion.The portal vein phase and delayed phase lesion enhancement gradually extended to the muscular layer and serous layer.All limited type GBA showed the papillary change.The typical"girth sign"can be seen in segmental GBA,and a few of them showed segmental thickening at the bottom of the body.Typical"garland sign"could be seen in all diffuse GBA.The display rate of rokitansky-aschoff sinuses(RAS)in GBA by MRI was significantly higher than that by CT.Conclusion The GBA had the characteristic image performance.The recognition of its imaging characteristic was advantageous to improve the preoperative diagnosis accuracy.

关 键 词：64排螺旋CT 磁共振成像 胆囊腺肌瘤病 罗-阿氏窦 

分 类 号：R575.6[医药卫生—消化系统]