动态多期螺旋CT扫描在肝内胆管细胞癌诊断中的价值

目的探讨螺旋CT动态增强扫描在肝内胆管细胞癌诊断中的应用价值。方法对经手术病理证实的30例肝内胆管细胞癌的CT资料进行回顾性分析。结果 30例患者中,肿瘤型18例,平扫表现为肝内单发的低密度不规则肿块,增强动脉期病灶无强化6例,外周部分呈轻度、不完全的环状强化12例,门脉期病灶进一步强化14例,延迟扫描病灶内部呈斑片状持续强化6例、网状或线状持续强化8例,病灶中央始终不强化4例;浸润型4例,平扫表现为肝内胆管壁局限性增厚、管腔狭窄,于增强后各期胆管壁缓慢持续强化;腔内生长型8例,平扫示近肝门部局限性软组织肿块并见肝管扩张增粗及狭窄,增强后近肝门肿块缓慢持续强化。结论螺旋CT动态增强扫描对提高肝内胆管细胞癌的正确诊断率具有一定价值。

Dynamic-multiphasic spiral CT diagnosis of intrahepatic cholangiocarcinoma

Objective To assess the value of dynamic-multiphasic spiral CT scans for diagnosing intrahepatic cholangiocarcinoma（IHCC） . Methods CT data of 30 patients with clinically and pathologically proved IHCC were analyzed retrospectively. Results The study demenstrated that there were 18 tumor pattern lesions,4 invasion pattern lesions and 8 intra-luminal growth pattern lesions in 30 IHCC patients. On precontrast CT images,tumor pattern lesions appeared as intrahepatic single mass with low density and irregular shape,on postcontrast arterial phase images,non-enhanced lesions were seen in 6 cases,perilesional slight and incomplete circular enhancement in 12 cases,on portar venous phase images,progressively enhanced lesions in 14 cases,on delayed phase images,intralesional patchy progressive enhancement in 6 cases,reticular or linear progressive enhancement in 8 cases,and always non-enhanced focal centers in 4 cases. Invasion pattern lesions appeared as intrahepatic bile duct wall thickening and luminal narrowing on precontrast CT images and then slowly progressive enhancement of bile duct walls on postcontrast CT images.Intraluminal growth pattern lesions appenred as local soft tissue masses near the hepatic porta and hepatic duct dilatation,thickening and stenosis on precontrast CT images,and then slowly progressive enhancement of these masses on postcontrast CT images. Conclusion Dynamic-multiphasic spiral CT scan plays important role in the diagnosis of IHCC.