肝门区胆管癌的CT表现与病理对照（附15例分析）

目的：探讨肝门区胆管癌的CT影像表现与诊断价值。方法：搜集15例经手术和病理证实的肝门区胆管癌，分析肝门区胆管癌CT影像特征和病理基础。结果：6例CT平扫表现为肝门区低密度软组织肿块，9例表现为肝门区胆管壁不规则增厚，动态增强后11例有延迟强化，CT值增加15～30HU。对照CT表现与手术所见，CT显示肝脏、肝门区动脉、门静脉、胆囊、肝门区淋巴结转移、腹膜后淋巴结浸润或转移；其它神经、脂肪受浸、腹膜种植在CT上均无明确显示。结论：肝门区胆管壁不规则增厚或软组织肿块伴肝内胆管扩张是肝门区胆管癌的CT基本影像表现，CT是检出和识别肝门区胆管癌的重要方法，但在判断肿瘤周围浸润的程度时仍有一定局限性。

CT manifestations and pathological basis of hepatic hilarcholangiocarcinoma(analysis of 15 cases)

Objective:To study the value of CT diagnosis and manifestations of CT in hepatic hilar cholangiocarcinoma.Methods:CT features of 15 patients with surgically and pathologically-proved hepatic hilar cholangiocarcinoma and the pathological basis were analyzed. Results:6 of 15 cases were lower density localized masses in hepatic portal,9 of 15 cases were wall-thicking accompanied with hepatic hilar,11 of 15 cases contrast CT were delay enhancement on dynamic scaning,the CT density rises from 15 to 30HU,all cases accompanied with cholangiectasis of liver.Comparison with CT images and operation,CT manifestations in liver?hepatic portal area were demonstrated,artery?portal vein?bile-cyst?lymphonodi of hepatic portal ?retroperitoneal lymphonodi but nerves or fat encroach and peritoneum metastasis were not found in CT images. Conclusion:Wall-thicking of hilar or localized masses and cholangiectasis of liver were the basis manifestations in hepatic hilar cholangiocarcinoma images.CT was an important method for the diagnosis of hepatic hilar cholangiocarcinoma,but it is still unsatisfactory for CT to determine the involvement extent of hilar cholangiocarcinoma.