胆管癌MR和CT征象分析  

Comparative analysis of MRI And CT imaging features in bile duct carcinoma

作　　者：刘翠娥[1] 王巍巍 冯锐 郑增 LIU Cui-e;WANG Wei-wei;FENG Rui;ZHENG Zeng(Department of Emergency,The Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100039,China;Department of Radiology,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第二医学中心门诊部急诊医学科,国家老年疾病临床医学研究中心,北京100039 [2]中国人民解放军总医院第五医学中心放射诊断科

出　　处：《肝脏》2024年第2期208-210,219,共4页Chinese Hepatology

摘　　要：目的总结分析胆管癌MR和CT直接征象和间接征象。方法收集整理2019年3月—2022年10月解放军总医院第五医学中心胆管癌手术切除且于术前1周内行MR或CT动态增强扫描检查的病例62例,分析各序列及动态增强扫描影像征象,总结各影像表现的出现率。结果62例患者中病灶大小介于(0.8~8.9)cm×4.2 cm之间,MR检查病灶表现为T1WI高信号4例、等信号2例、低信号36例、不均匀1例,T2WI高信号35例、等信号3例、低信号3例、不均匀2例,DWI序列高信号40例,等信号3例,明显强化19例,轻度强化17例,无强化6例,快进快出型强化19例,持续强化24例,延迟强化11例。CT扫描病灶表现为平扫2例病灶为等密度,3例为稍高密度,14例为稍低密度;碘氟醇动态增强扫描,动脉期轻度强化12例,显著强化4例,无强化3例;门脉期稍高密度7例,稍低密度7例,高密度4例,等密度1例;延迟期稍高密度10例,稍低密度5例,等密度2例,高密度2例。间接征象包括胆管扩张,62例患者中胆管扩张47例,其中枯枝状扩张38例,软藤状扩张3例,枯枝状伴软藤状扩张4例,蚯蚓状扩张2例。结论病灶延迟强化和持续强化及枯枝状胆管扩张是胆管癌MR和CT扫描典型的直接征象和间接征象。Objective To summarize both direct and indirect imaging characteristics of cholangiocarcinoma as revealed by MRI And CT scans.Methods Data were retrospectively collected and analyzed from 62 cholangiocarcinoma resection cases at the Fifth Medical Center of PLA General Hospital,spanning from March 2019 to October 2022.These patients had undergone either MR Or CT dynamic enhancement scans within 1 week prior to their surgery.The imaging sequences and dynamic enhancement scan features were meticulously analyzed,with the prevalence of each distinct radiologic sign observed in these patients being quantified.Results In this study of 62 cholangiocarcinoma patients,lesion sizes ranged from 0.8 to 8.9cm in the longest dimension.,MRI analysis revealed varid signal intensities:on T1WI,lesions exhibited high signal in 4 cases,isointense signal in 2,low signal in 36,and heterogeneous signal in 1.On T2WI,35cases showed high signals,3 isointense,3 low signal,and 2 heterogeneous.Diffusion-weighted imaging(DWI)identified high signal in 40 cases and isointense signal in 3.Enhancement patterins included pronounced enhancement in 19 cases,mild in 17,absent in 6,rapid in-and out in.19,continuous 24 and delayed in 11.CT imaging revealed isodensity in 2 cases,slightly hyperdense in 3 and slightly hypodense in 14.Enhancement patterns on CT were mild in,12 cases,marked in 4,and absent in 3.In the portal venous phases,7 patients presented with slightly hyperdense lesions,7 with slightly hypodense,4 with hyperdense,and 1 with isodense lesions.Additonal findings included 10 cases with slightly hyperdense lesions,5 with slightly hypodense,2 with isodense,and 2 with hyperdense.Indirect signs of cholangiocarcinoma,such as biliary dilation,were noted in 47 of the 62 patients.This included 38 cases of mild dilation,3 moderate,4 severe with soft vine appearance,and 2 showing earthworm-like dilation.Conclusion Delayed and continuous enhancement patterns,along with biliary duct dilatation,are identified as hallmark direct and indirect signs in MRI

关 键 词：胆管癌 MR CT 胆管扩张 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R735.8[医药卫生—临床医学]