肝门胆管癌的MSC对照CT表现与病理

目的探讨螺旋CT对肝门胆管癌的诊断价值。方法回顾性分析经手术、病理证实的25例肝门胆管癌,所有病例均行CT平扫及强化扫描,通过观察各型胆管癌的平扫、增强表现,重点分析肿瘤的强化程度、方式、时间以及各种重要间接征像。结果25例中除1例乳头型小结节CT未能显示,其余24例均被CT检出。增强扫描显示25例肿瘤均呈缓慢持续强化;25例均出现阻塞性肝内胆管扩张;8例出现肝门、腹膜后淋巴结转移;6例出现肝叶萎缩。结论肿瘤的缓慢持续强化是肝门胆管癌的相对特征表现;肝内胆管的阻塞性扩张是胆管癌的主要间接征象;淋巴结转移、肝叶萎缩肝实质侵犯等可作为有力的诊断依据。螺旋CT动态扫描具有一定特征性为肝门胆管癌的主要检查手段。

MSCT appearance of hepatic hilar cholangiocarcinoma with pathologic correlation

Objective: To investigate the diagnostic value of MSCT in the hepatic hilar cholangiocarcinoma.Methods: Twenty-five cases of hepatic hilar cholangiocarcinoma pathologically proved by surgery or biopsy were retrospectively analyzed.All patients had been examined with plain and dynamic enhancement scan.Various types of cholangiocarcinoma were maily analyzed by observing the plain,enhancement performance,focusing on the enhancement of the extent of tumor,pattern,time and various important indirect signs.Results: In 25 cases,except 1case nipple of small nodules,the remaining 24 cases were detected by CT.The findings of slowly and continuing enhanced was found in 25 patients;The obstructive intrahepatic cholangiectasis was found in 25 patients;Metastasis of lymph nodes in the hepatic portal and retroperitone were found in 8 cases.Hepatic lobe atrophy existed in 6 patients.Conclusion: The signs of slowly and continuing enhanced of the hepatic hilar cholangiocarcinoma are the relative characteristics;The obstructive intrahepatic cholangiectasis are indirect signs;The evidence of diagnosis is metastasis of lymph nodes,liver atrophy and liver substance abuse.The feature of hepatic hilar cholangiocarcinoma is somewhat specific on the dynamic enhancement spiral CT scanning.