CT诊断肝脏胆管导管内乳头状黏液性肿瘤临床案例分析  

Diagnosing Intraductal Papillary Mucinous Neoplasm of the Bile Duct with Computed Tomography:A Clinical Case Analysis

作　　者：王新正 方进智 于大飞 曾建兵 张玉忠 鄂林宁 WANG Xinzheng;FANG Jinzhi;YU Dafei;ZENG Jianbing;ZHANG Yuzhong;E Linning(Department of Radiology,Longhua People’s Hospital of Shenzhen,Shenzhen 518109,China)

机构地区：[1]深圳市龙华区人民医院医学影像科,广东深圳518109

出　　处：《CT理论与应用研究(中英文)》2025年第1期155-162,共8页Computerized Tomography Theory and Applications

摘　　要：目的:探讨肝脏胆管导管内乳头状黏液性肿瘤(IPMN-B)的CT特征。方法:回顾性分析3例经手术病理证实为IPMN-B患者的临床资料、CT表现,并复习文献。结果:3例IPMN-B的CT表现为类圆形囊性病灶,病灶内可见实性附壁结节或带蒂的乳头状软组织密度影,病灶与胆管相通,周边胆管可见不同程度扩张。增强扫描3例病灶内实性成份轻-中度不均匀强化,囊性成份未见强化。其中1例IPMN-B患者4年内3次复查,病灶逐渐增大并恶变;3例肝周及腹膜后均未见淋巴结肿大。结论:肝内胆管内乳头状肿瘤特征性的CT表现为边界清晰的囊性病灶,伴有实性壁结节或肿块,大部分病灶与胆管相通并伴有胆管扩张。Objective:This study aimed to explore the computed tomography(CT)features of the intraductal papillary mucinous neoplasm of the bile duct(IPMN-B).Methods:A retrospective analysis was conducted on the clinical data and CT findings of three patients with surgically and pathologically confirmed IPMN-B.Additionally,a review of the relevant literature was performed.Results:All three IPMN-B cases exhibited well-defined circular cystic lesions on CT cans.These lesions contained solid mural nodules or soft tissue densities with visible pedicles within the cysts.Notably,the lesions connected to the bile duct,and surrounding bile ducts showed varying degrees of dilation.Enhanced CT scans revealed mild to moderate uneven enhancement within the solid components of all three lesions,while the cystic components displayed no enhancement.Interestingly,one patient with IPMN-B underwent follow-up examinations over four years,demonstrating gradual enlargement and malignant transformation of the lesion.None of the three cases showed lymph node enlargement around the liver or retroperitoneum.Conclusion:The study suggests characteristic CT features of IPMN-B.These include well-defined cystic lesions with accompanying solid wall nodules or masses.Additionally,most lesions connect to the bile duct and are accompanied by bile duct dilation.

关 键 词：CT 胆管导管内乳头状黏液性肿瘤 诊断 

分 类 号：R814[医药卫生—影像医学与核医学]