70例胆管细胞癌的多期CT增强扫描特征分析

目的通过分析胆管细胞癌多期CT增强扫描特征,为胆管细胞癌临床诊断提供影像学依据。方法回顾性分析本院2014年1月-2016年5月经病理证实70例胆管细胞癌CT影像学资料,观察CT平扫、多期(动脉期、静脉期、延迟期)增强扫描表现。结果 CT平扫显示单发胆管细胞癌70例,肝左叶发病居多(占64.29%),病灶直径平均6.5cm;伴肝内胆管结石25.71%,伴肝左叶萎缩20.00%。CT平扫显示肿块型45例,占64.29%,平扫表现为低密度影,边界不清,动脉期显示病灶无强化14例,边缘轻度强化28例,静脉期显示病灶中心进一步网状强化14例,延迟期显示线状或不均匀网状持续强化18例;腔内生长型19例,平扫显示肝门部周边软组织肿块存在,动脉期显示肝门不周边软组织肿块轻度强化,静脉期则进一步强化,延迟期缓慢持续强化;浸润型9例,平扫显示胆管壁增厚、管腔狭窄,动脉期肝内胆管壁轻度强化,静脉期进一步强化,延迟期则缓慢持续强化。结论 CT平扫及多期增强扫描诊断胆管细胞癌有一定的特异性,有利于胆管细胞癌早期正确诊断。

A Feature Analysis of Multi-phase CT Enhancement Scan on 70 Cases of Cholangiocarcinoma

Objective To provide imaging bases for clinical diagnosis of cholangiocarcinoma through analyzing multi-phase CT enhanced scan characteristics of cholangiocarcinoma. Methods A retrospective analysis of CT imaging data of cholangiocarcinoma confirmed by pathology was carried out in 70 cases in our hospital from January 2014 to May 2016, enhancement scanning findings of CT scan, multiple phase (arterial phase, venous phase and delayed phase) were observed.Results CT scan showed that there were 70 cases of single cholangiocarcinoma, mostly in left lobe of liver (64.29%), average lesion diameter was 6.5cm. 25.71% were complicated with hepatolith, 20.00% were complicated with left hepatic lobe atrophy. CT scan showed that there were 45 cases of massive type, which accounted for 64.29%, scan findings were low-density shadow, obscure boundary, arterial phase showed that there were no enhancement of lesion in 14 cases, margin mild enhancement in 28 cases, venous phase showed that there were 14 cases of lesion center further reticular enhancement, delayed phase showed that there were 18 cases of striation or inhomogeneous reticular continuous enhancement. 19 cases of cavity growth type, scan showed that there were hepatic portal peripheral soft tissue mass, arterial phase showed that there were hepatic portal peripheral soft tissue mass mild enhancement, venous phase were further enhancement, delayed phase were slow continuous enhancement; 9 cases of infiltrative type, scan showed bile duct wall thickening, lumen stenosis, bile duct wall in the liver were mild enhancement in arterial phase, venous phase were further enhancement, delayed phase were slow continuous enhancement. Conclusion CT scan and multi-phase enhanced scan has a certain specificity in the diagnosis of cholangiocarcinoma, which is conducive to the early correct diagnosis of cholangiocarcinoma.