肝内胆管细胞癌的CT诊断

目的探讨周围型肝内胆管细胞癌的CT表现及解剖，并与其它肝内肿瘤进行鉴别。方法回顾性分析经手术及穿刺病理证实的35例周围型肝内胆管细胞癌的cT资料。结果35例患者中，左肝24例，右肝9例，左右肝受累2例，28例为单发病灶，大小为3—10cm，7例为多发大小不一病灶，肝内胆管扩张26例，肝内胆管结石20例，肝叶萎缩12例，局部肝轮廓凹陷7例。增强扫描可见动脉期和静脉期边缘轻度强化，且不同程度出现线样和网格状强化，延迟扫描，随着时间的延长病灶逐步由边缘向中心强化，最后病灶强化高于肝实质，延迟扫描的表现有一定的诊断价值。结论周围型胆管细胞癌的CT表现及好发部位具有一定的特征性，可以和肝内其它占位性病变鉴别，其中又以螺旋CT多期增强扫描具有较高的诊断价值。

CT Diagnosis of Intrahepatic Peripheral Cholangiocarcinoma

Objective To investigate CT features and anatomy characters of intrahepatic peripheral cholangiocarcinoma, and differential diagnosis of intrahepatic space - occupying lesions. Methods CT findings of 35 cases of intrahepatio peripheral eholangiocareinoma surgically and pathologically confirmed were retrospectively analyzed. Results Of all 35 cases, tumor involved left lobe of liver（ 24 cases ）, right lobe （ 9 cases ） , both left and right lobes （ 2 cases ）. 28 cases were single mass with a diameter of 3 - 10 cm and 7 cases were multiple lesions with various sizes. Dilation of intrahepatie biliary duct（26 eases）, hepatolith（20 eases）, atrophy of liver lobe（12 cases） , retraction of liver capsule adjacent to the tumor（7 eases） were found. Mild enhancement of the lesion margin in arterial phase and portal -venous phase and linear or reticular enhancement was seen in all cases. In delayed scan there was progress enhancement from periphery to center, at last the lesion was higher than that of normal liver. Conclusions CT features of intrahepatie peripheral cholangiocarcinoma have some extent common characteristics, which are useful in the differential diagnosis of space - occupying lesions in liver, MSCT multi - phase scan is especially useful.