成人多发胆管性错构瘤的CT、MRI表现

目的:探讨成人多发胆管性错构瘤的CT、MRI表现,以提高对本病的认识。方法:回顾性分析经穿刺活检病理证实的3例成人多发性胆管性错构瘤患者的CT、MRI表现,并结合文献,对此病的病理、临床及影像特点进行讨论。结果:CT平扫显示病灶呈多发低密度,增强扫描无强化。MRI平扫显示病灶呈长T1长T 2信号,增强扫描无强化。MRCP显示肝内多发类囊状高信号病灶,与胆管不相通。结论:应用多层螺旋CT及高场磁共振可清楚显示本病特点,能够明确诊断。     

胆管错构瘤的CT及MRI表现

目的:分析胆管错构瘤的CT及MRI特点,以提高对该病的诊断水平。方法:回顾性分析我院经病理证实的肝内胆管错构瘤13例患者的CT或MRI资料,观察病变在CT及MRI图像上的分布、大小、形态及强化特点。结果:CT平扫主要表现为肝内低密度的囊状病变灶,病灶直径小于10mm,CT增强扫描无强化;MRI主要表现为T1WI上病变信号低于肝实质,T2WI病灶显示清楚,呈明显的高信号,增强扫描病灶未见强化,部分病灶出现边缘强化;MRCP显示肝内多发囊性病变与肝内胆管不相通。结论:胆管错构瘤的CT及MRI表现有一定的特征性,有助于对该病的诊断。     

胆管板畸形及其CT与MRI评价

胆管板畸形(ductal plate malformation)是一组以肝内外胆管发育异常为特征的复杂畸形,包括从胆管错构瘤、先天性肝纤维化到各种胆管囊肿的一系列疾病。这些疾病可单独出现,也可合并存在,还有可能伴随显性遗传性多囊肾病(autosomal     

成人多发性胆管错构瘤1例

患者男,18岁。因腹胀伴乏力、食欲下降、尿黄20余天入院。查体：面色晦暗,皮肤、巩膜轻度黄染,全身浅表淋巴结不肿大。心肺未见异常。腹部膨隆,肝大、质地中等,有触痛,莫菲征阴性,脾肋下未及,肝上界于右锁骨中线第Ⅴ肋间,肝区无叩痛,腹腔积液征阳性,双下肢无浮肿。实验室检查：总蛋白45g/L,清蛋白28g/L,总胆红素34．1μmol／L,直接胆红素16．3μmol／L,丙氨酸转氨酶27U／L,天冬氨酸转氨酶65U/L,碱性磷酸酶113U／L,     

成人单发肝脏胆管错构瘤2例

例1患者,女,25岁。2006年9月自觉上腹部不适于外院CT检查示"肝内胆管囊性扩张或囊腺瘤可能"。于2006年9月13日为求进一步诊治入院。体检及实验室检查均无明显异常。MRI示:T1WI肝门部可见多发小囊状聚集呈簇状低信号影(图1),大小约6cm×7cm,边缘尚清楚,内     

肝内胆管囊腺瘤CT、MRI诊断

目的:总结肝内胆管囊腺瘤CT、MRI表现特点,评价CT、MRI对其诊断价值.方法:回顾性分析经手术病理证实的5例肝内胆管囊腺瘤临床及CT、MRI资料.结果:男2例,女3例;肝左叶4例,右叶1例;5例均为单发,单房2例.多房3例,囊壁结节或乳头状突起3例,囊壁点状钙化1例,胆总管囊状扩张2例,增强扫描囊壁、分隔、壁结节及乳头状突起强化.结论:肝内胆管囊腺瘤CT、MRI表现具有特征性,囊性病变伴有分隔、囊壁结节或乳头状突起提示囊腺瘤诊断,胆总管明显扩张是诊断与胆管相通粘液性囊腺瘤的一个重要间接征象.     

肝脏多发胆管错构瘤的MRI表现(附4例报告并文献复习)

目的探讨肝脏多发胆管错构瘤的磁共振成像(MRI)特点,以提高对该病的诊断水平。方法回顾性分析经本院证实的4例肝脏多发胆管错构瘤患者的MRI资料,观察病变的分布、大小、形态及信号特点。结果肝脏多发胆管错构瘤MRI为肝脏弥漫或局限分布的囊性病灶,边界清楚,形态各异,大小不一,直径通常小于15mm;平扫T_1WI呈低信号,信号低于肝实质,T_2WI病灶显示为明显的高信号,同、反相位比较,信号未见明显变化,弥散加权成像病灶弥散不受限,增强扫描病灶未见强化,部分病灶可出现边缘强化;磁共振胰胆管水成像(MRCP)表现为肝脏多发囊性结节,如"满天星"表现,所有病变与肝内胆管不相通。结论肝脏多发胆管错构瘤的MRI表现有一定的特征性,对本病的诊断有重要价值,但最终确诊有赖于采用活体组织进行病理学检查。     

脾脏错构瘤的CT和MRI表现

目的:探讨脾脏错构瘤(SH)的CT和MRI表现.方法:回顾性分析6例病理确诊的SH患者的CT和MRI影像学表现.结果:6例SH中5例为单发,1例为多发.病灶在CT平扫呈等或稍低密度,在T1WI上呈等或稍低信号,在T2WI上呈不均匀低信号(4例)或高信号(2例),其中2例病灶中心出现局灶异常信号.动态增强扫描4例病灶表现为早期弥漫不均匀轻度强化并随时间推移呈渐进性延迟性强化,2例表现为早期均匀较明显强化,2例病灶中心的局灶异常信号呈部分延迟强化.结论:SH的CT和MRI表现具有一定特征性,影像学检查特别是MRI是诊断SH的重要方法.     

下丘脑错构瘤的MRI及CT表现

下丘脑错构瘤是一种先天性疾病,发病率低,发病原因为胎儿发育期间神经管闭合不全,多起自灰结节和乳头体.现回顾性分析笔者在北京天坛医院进修时收集到的12例下丘脑错构瘤的临床及影像学表现,并复习相关文献资料,以提高对本病的认识.     

下丘脑错构瘤的CT和MRI诊断

目的：研究下丘脑错构瘤的CT和MRI影像表现,探讨影像学,临床及预后的关系。方法：分析了2例下丘脑错构瘤的CT和MRI资料,其中男1例,女1例,年龄1．5－2岁,1例行CT平扫和增强,另1例行MRI平扫和增强,又作了CT平扫。2例均经手术和病理证实。结果：全部病例临床表现主要为性早熟和痴笑样癫痫,肿块与灰结节或乳头体相连,CT表现为与皮质等密度的不增强肿块,MRI表现在T1WI上与灰质等信号,在PDW和T2WI上等信号或轻度高信号,肿块不增强,结论：如患儿临床上表现为性早熟和痴笑样癫痫,影像学上显示灰结或乳头体肿块,具有典型CT和MRI表现,应首先考虑本病,本病应与颅咽管瘤,下丘脑胶质瘤,生殖细胞瘤鉴别。     

肝内胆管错构瘤5例的磁共振成像诊断及鉴别诊断简

目的：探讨成人肝脏胆管错构瘤的影像学表现,以提高对本病的认识。方法回顾性分析5例经手术、病理证实的肝内胆管错构瘤的影像学表现。对所有患者均行磁共振成像（MRI）平扫、磁共振胰胆管造影（MRCP）、增强扫描,并穿刺活检病理证实。结果 T1WI病变呈低于肝实质的信号,呈多发,沿血管胆管树分布, T2WI病灶显示清楚,呈明显的高信号,在MRCP序列上,多数病变显示为高信号,与T2WI比较,显示的病变数量有所减少。MRCP显示肝内多发类囊状高信号病变,与可见的胆管树不相通。增强扫描示各期病灶无强化,在增强扫描60 s,3 min肝实质明显强化,小囊状信号未见明显强化,形成明显的对比。结论成人肝内胆管错构瘤在影像学上无特征性表现,类似于肝转移瘤、肝脓肿、肝海绵状血管瘤等常见的肝囊性占位病变。     

Multicystic biliary hamartoma mimicking intrahepatic bile duct cancer

Although multicystic biliary hamartoma of the liver is a rare entity, recently several case reports have been described. The criteria proposed by Zen et al. include the presence of honeycomb-like nodules located around the hepatic capsule that are close to the hepatic falciform ligament and characteristically protrude from the liver.In this report, we present a case of multicystic biliary hamartoma, which also features intrahepatic bile duct dilatation, and could therefore mimic a malignant neoplasm such as bile duct carcinoma. Our case highlights the potential difficulties in differentiating between multicystic biliary hamartoma and bile duct carcinomas under such circumstances.     

Differentiating malignant from benign common bile duct stricture with multiphasic helical CT

PURPOSE: To evaluate retrospectively the use of multiphasic helical computed tomography (CT) to differentiate malignant and benign common bile duct (CBD) strictures in patients with only a focal CBD stricture and to determine predictors for this differentiation. MATERIALS AND METHODS: Institutional review board approval and informed patient consent were not required. Fifty patients (35 men, 15 women; age range, 35-87 years; mean age, 61.6 years) with only a focal CBD stricture comprised the sample for this study (32 malignant and 18 benign strictures). The diagnosis of all malignant and five benign CBD strictures was confirmed by reviewing patients' surgical and pathology records; in 13 benign CBD strictures, the diagnosis was confirmed by means of clinical features. Multiphasic CT findings were analyzed with regard to the wall thickness, location, length, and enhancement pattern of the involved CBD, the upstream CBD diameter, and other findings. CT features to identify benign and malignant CBD strictures were compared by means of univariate analysis and multivariable stepwise logistic regression analysis. RESULTS: Malignant strictures were longer (17.9 mm +/- 6.6 [+/- standard deviation]) than benign strictures (8.9 mm +/- 6.8) (P < .0001), and upstream CBD diameters were larger in malignant cases (22.0 mm +/- 5.4) than in benign cases (17.8 mm +/- 4.6) (P = .033). The involved wall thickness was more than 1.5 mm in 26 malignant cases and three benign cases (P < .0001). During both hepatic arterial and portal venous phases, greater enhancement than that in the normal CBD were more frequently observed in malignant cases (in 27 and 30 patients for hepatic arterial and portal venous phase scans, respectively) than in benign cases (in two and three patients, respectively) (P < .0001). Results of multivariable stepwise logistic regression analysis showed that hyperenhancement of the involved CBD during the portal venous phase was the only variable that could be used to independently differentiate malignant from benign strictures. CONCLUSION: Hyperenhancement of the involved CBD during the portal venous phase is the main factor distinguishing malignant from benign CBD strictures.     

Dynamic test in the echographic evaluation of the common bile duct

Common bile duct (CBD) diameter was measured with ultrasonography in 396 patients (131 had previous cholecystectomy) before and 40 minutes after the ingestion of a fatty meal. CBD diameter reduced in 177 cases, remained unchanged in 175, increased in 44. The increasing of CBD diameter always means obstructive choledochal pathology, caused by stones or other pathologic conditions. Caliber reduction or other pathologic conditions. Caliber reduction is physiologic. When CBD remains unchanged, in 10% of the cases there are stones in the duct.     

Ultrasonic cholangiography. Gray-scale B-scan evaluation of the common bile duct.

Gray-scale B-scanning permits evaluation of major portions of the bile ducts, especially those with significant dilatation. Injection of contrast material containing microscopic air bubbles through a T-tube with simultaneous ultrasonography detected multiple echoes filling in the previously echo-free area which represented the common bile duct, outlining both the duct and portions of the major tributaries. Reflections could be obtained from stones within the duct. Follow-up examinations after surgery could be used to demonstrate shrinkage of the duct. Jaundice due to extra- or intrahepatic obstruction was successfully differentiated noninvasively.