黄色肉芽肿性胆囊炎的影像学表现

目的：探讨黄色肉芽肿性胆囊炎（XGC）的CT和MRI表现。方法：回顾性分析8例经手术病理证实的XGC,总结其CT和MRI表现。结果：术前诊断为XGC2例,误诊为胆囊癌6例。CT表现：8例均有胆囊壁增厚,其中局限性增厚表现为动脉期环形强化1例,弥漫性增厚表现为夹心饼干征3例,4例表现为胆囊黏膜线完整;伴胆囊结石5例,胆总管结石1例,右肝内胆管细胞癌1例。MRI表现：3例T2WI表现为胆囊壁内高信号结节,2例门脉期及延迟期清晰显示明显强化的完整的胆囊黏膜线。结论：CT增强扫描表现环形强化和夹心饼干征;MRI扫描T2WI表现为胆囊壁内高信号结节,增强扫描显示明显强化的完整的胆囊黏膜线等表现,是提示XGC诊断的重要征象。

Imaging features of xanthogranulomatous cholecystitis

Objective：To discuss the features of CT and MRI in diagnosis of xanthogranulomatous cholecystitis （XGC）.Methods：The CT and MR imaging data of 8 cases of XGC proved by surgical pathology were collected and analyzed retrospectively.Results：Two cases were diagnosed correctly and 6 cases were misdiagnosed as gallbladder carcinoma before operation.CT imaging features：gallbladder wall thickening was demonstrated in 8 cases,from which one case had focal thickening showing ring-shaped enhancement in arterial phase,3 cases showed hypodense band sign having pervasive thickening.Mucosal line was intact in 4 cases.Gall bladder stone was found in 5 cases,common bile duct stone in 1 case,and cholangiocarcinoma in right lobe in one case.MR imaging features：3 cases showed high-signal nodules on T2WI;2 cases showed intensive enhancement of a intact mucosal line in portal venous phase and delayed phase.Conclusion：Ring-shaped enhancement and ＂hypodense band sign＂ on contrast-enhanced CT,hyperintense nodules of gallbladder wall on T2WI with intensive enhancement of intact mucosal line on contrast-enhanced MRI are important features suggestiag xanthogranulomatous cholecystitis.