肝胆管囊腺瘤和囊腺癌的CT、MRI表现及其与病理对照分析  

CT and MRI findings of Cystadenoma and Cystadenocarcinoma of Hepatobiliary Duct and Their Contrast with Pathology

作　　者：陈天忠 刘艳萍 黄宝晗 CHEN Tian-zhong;LIU Yan-ping;HUANG Bao-han(Department of Radiology,Guangxi Zhuang Autonomous Region Brain Hospital,Liuzhou 545000,Guangxi,China)

机构地区：[1]广西壮族自治区脑科医院放射科,广西柳州545000

出　　处：《中国CT和MRI杂志》2024年第3期106-108,共3页Chinese Journal of CT and MRI

摘　　要：目的 探讨肝胆管囊腺瘤和囊腺癌的CT及MRI表现,并与病理对照分析,以提高对该病的术前影像诊断准确性及鉴别诊断水平。方法 回顾性分析经手术病理证实的11例肝胆管囊腺瘤及囊腺癌患者的影像学征象及病理学特点,其中9例均行CT平扫及三期增强扫描,5例同时行MRI平扫及动态增强扫描。结果 在11例患者中,囊腺瘤8例,囊腺癌3例:11例均为单发,肝左叶7例,右叶3例,肝多叶受累1例;1例囊腺瘤为单囊性病灶,囊壁光整,CT见囊内主要表现为水样密度;1例囊腺癌以实性成为主,其余9例囊腺瘤及囊腺癌呈多发囊状,5例囊腺瘤囊壁光整,厚薄一致,部分分隔均匀增厚,增强扫描无强化或轻度强化;2例囊腺瘤有囊壁钙化;2例囊腺癌囊壁及其内分隔厚薄不一,增强扫描可见实性结节强化,门静脉期强化减退,呈“结节”状或“菜花状”,部分断面锯齿状改变。结论 肝胆管囊腺瘤及囊腺癌的CT、MRI表现,充分反映其病理学特点,注意病变的一些影像学特征性表现,如分隔不均匀增厚,囊壁“结节”或“菜花样”突起及伴有粗大钙化,在囊腺瘤及囊腺癌的鉴别诊断上具有重要意义。Objective To investigate the CT and MRI features of hepatobiliary duct cystadenoma and cystadenocarcinoma of hepatobiliary duct,and to compare with the pathological analysis,so as to improve the imaging diagnosis and differential diagnosis of this disease.Methods The imaging findings and pathological features of 11 patients with cystadenoma and cystadenocarcinoma of the hepatic duct confirmed by surgery and pathology were analyzed retrospectively.CT plain scan and dynamic enhancement scan were performed in 9 cases,and MRI plain scan and dynamic enhancement scan were performed in 5 cases.Results Among the 11 patients,8 cases of cystadenoma,3 cases of cystadenocarcinoma:11 cases were single,7 cases of left lobe,3 cases of right lobe,1 case of multiple lobe of liver involvement;1 case of cystadenoma was a single cystic lesion,the cyst wall was smooth,and CT showed that the cyst was mainly characterized by water density.1 case of cystadenocarcinoma was mainly solid,the other 9 cases of cystadenoma and cystadenocarcinoma presented multiple cystlike,5 cases of cystadenoma cyst wall was smooth,the thickness was consistent,part of the separation was evenly thickened,no enhancement or mild enhancement on enhanced scan.Calcification of cyst wall was found in 2 cases of cystadenoma.In 2 cases of cystadenocarcinoma,the thickness of the cyst wall and the separation were different,enhanced solid nodules could be seen on enhanced scanning,and the enhancement decreased in the portal vein stage,showing"papillary"or"cauliflower"nodules,and some sections were serrate.Conclusion CT and MRI findings of cystadenoma and cystadenocarcinoma of hepatobiliary duct fully reflect their pathological characteristics.Attention should be paid to some imaging characteristics of the lesions,such as uneven thickening of septum,"papilla"or"flower"protrusions of cyst wall and coarse calcification,which are of great significance in the differential diagnosis of cystadenoma and cystadenocarcinoma.

关 键 词：胆管肿瘤 囊腺瘤 囊腺癌 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]