周围型肝内胆管细胞癌的动态螺旋CT诊断

目的:探讨周围型肝内胆管细胞癌(PICC)的螺旋CT平扫和动态增强特征。方法:回顾性分析经手术或穿刺病理证实的周围型胆管细胞癌13例,男5例,女8例,年龄38~72岁(平均58岁),全部病例均行平扫和增强扫描。结果:13例中,平扫7例病灶呈圆形、类圆形,6例呈分叶状及不规则形低密度影。肝内胆管扩张11例,肝内胆管结石5例,肝叶萎缩5例,局部肝轮廓凹陷4例。增强扫描,强化方式大致分为三种:①5例动脉期、门静脉期及延迟期不均匀强化,无渐进及向心性强化。②3例动脉期边缘强化,门脉期及延迟期渐进性向心性强化。③5例动脉期强化不明显,门脉期及延迟期肿瘤全体逐渐强化,强化表现:病灶不均匀强化,或呈线样或网格样,周边呈环样或条索样强化。结论:肝内胆管细胞癌的螺旋CT表现具有一定程度的特征性。

Diagnosis of peripheral intrahepatic cholangiocarcinoma using dynamic enhancement spiral CT scanning

Objective:To investigate the imaging features of on the plain and dynamic enhancement spiral CT scans.Methods: Thirteen cases of peripheral intrahepatic cholangiocarcinoma pathologically proved by surgery or biopsy were retrospectively analyzed,including 5 males and 8 females,aged from 38 years to 72 years with a mean of 58 years.All patients had been examined with plain and dynamic enhancement scan.Results: In 13 cases,the lesions were low attenuation,and were rounded or ovoid in 7 cases,and lobular and irregular in 6 cases respectively.The intrahepatic cholangiectasis was found in 11 patients,and intrahepatic bile duct stone in 5 patients.Hepatic lobe atrophy existed in 5 patients.A focally depressed contour was found in 4 patients.On the dynamic contrast scan,the lesion was inhomogeneous enhanced without centripetally progression in 5 cases.In 3 cases,the lesions were peripherally enhanced in the arterial phase,and centripetally progressed on the portal and delay phase.In the rest 5 cases,the lesions were not clearly enhanced on the arterial phase,but gradually enhanced on the portal and delay phase.The patterns of enhancement were symmetrical enhanced or linear and reticular in the central portion,and circular or streak in the rim.Conclusion: The feature of peripheral intrahepatic cholangiocarcinoma was somewhat specific on the dynamic enhancement spiral CT scanning.