胆囊少见肿瘤的MRI表现及文献复习  

MRI features of rare tumors of gallbladder and the literature review

作　　者：陈颖[1] 鲍宽主 刘佳伟 郝金钢[1] CHEN Ying;BAO Kuanzhu;LIU Jiawei;HAO Jingang(Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院放射科,云南昆明650101

出　　处：《实用放射学杂志》2023年第11期1797-1800,共4页Journal of Practical Radiology

基　　金：云南省医学学科带头人培养项目(D-2018012)。

摘　　要：目的探讨胆囊少见肿瘤的MRI表现。方法对23例经病理证实为胆囊少见肿瘤患者的MRI资料进行回顾性分析,其中胆囊腺鳞癌(ASCGB)10例,胆囊鳞状细胞癌(GBSCC)2例,神经内分泌肿瘤(NEN)7例,胆囊乳头状肿瘤3例,未分化癌(UC)1例。结果ASCGB和GBSCC表现为胆囊壁不规则增厚或T_(1)WI呈稍低信号、T_(2)WI呈不均匀稍高信号的肿块,增强扫描呈轻度渐进性强化,内可见稍长T_(1)、稍长T_(2)信号的坏死灶;NEN呈T_(1)WI不均匀稍低、T_(2)WI不均匀稍高信号,或仅表现为胆囊壁增厚,增强扫描表现为动脉期明显强化或渐进性强化;胆囊乳头状肿瘤表现为胆囊内稍长T_(1)、稍长T_(2)信号,扩散轻度受限,增强扫描呈渐进性强化;UC表现为胆囊内等至稍长T_(1)、稍长T_(2)的混杂信号,增强扫描呈渐进性强化。结论胆囊少见肿瘤的MRI表现有一定特征:ASCGB和GBSCC恶性程度高,早期出现周围侵犯,可见内部坏死;NEN边界清晰、黏膜倾向于完整;乳头状肿瘤为息肉样病变,以窄基底或茎与胆囊壁相连,胆囊壁形态正常;UC表现为胆囊内较大的息肉样肿块。最终确诊仍依赖病理。Objective To investigate the MRI features of rare tumors of gallbladder.Methods MRI data of 23 cases with rare tumor of gallbladder confirmed by pathology were analyzed retrospectively,including 10 cases with adenosquamous carcinoma of the gallbladder(ASCGB),2 cases with gallbladder squamous cell carcinoma(GBSCC),7 cases with neuroendocrine neoplasm(NEN),3 cases with intracholecystic papillary neoplasm of the gallbladder,and 1 case with undifferentiated carcinoma(UC).Results ASCGB and GBSCC manifested as irregular thickening of the gallbladder wall,or a mass with slight hypointensity on T_(1)WI and inhomogeneous slight hyperintensity on T_(2)WI,with slight progressive enhancement on enhanced MRI.There were foci of necrosis within the mass with slight hypointensity on T_(1)WI and slight hyperintensity on T_(2)WI.NEN had inhomogeneous slight hypointensity on T_(1)WI and inhomogeneous slight hyperintensity on T_(2)WI,or thickened gallbladder wall,and obvious enhancement in the arterial phase or progressive enhancement on enhanced MRI.Intracholecystic papillary neoplasm of the gallbladder showed slight hypointensity on T_(1)WI,slight hyperintensity on T_(2)WI and diffusion weighted imaging,and progressive enhancement.UC presented as intraluminal polypoid masses with iso-hypointensity on T_(1)WI and inhomogeneous slight hyperintensity on T_(2)WI,with progressive enhancement.Conclusion Rare tumors of gallbladder have certain MRI imaging features including high malignant ASCGB and GBSCC with early peripheral invasion and intratumorous necrosis,NEN with a well-defined margin and intact overlying mucosa,polypoid intracholecystic papillary neoplasm with a narrow neck in normal gallbladder wall,and UC with large intraluminal polypoid mass.The final diagnosis still relies on pathology.

关 键 词：胆囊 少见肿瘤 磁共振成像 

分 类 号：R735.8[医药卫生—肿瘤] R445.2[医药卫生—临床医学]