胆管癌的MRI诊断(附32例报告)

目的：探讨胆管癌的MR表现及鉴别诊断，方法：收集32例经手术，病理证实的胆管癌，回顾性分析其MR表现，结果：肝内胆管癌2例，MR表现为肝内块状长T1长T2信号，可见中心瘢痕，卫星结节，增强后呈中度环形强化，肝门胆管癌18例，MR表现为肝内胆管扩张，胆总管或左右肝管起始部狭窄，充盈缺损，肝门软组织肿块，中下段胆管癌12例，MR表现为肝内胆管扩张，病变以上胆总管扩张，病变胆总管狭窄，中断及周围软组织肿块，MRCP对扩张的肝内胆管，胆总管及狭窄端胆总管形态显示良好。结论：肝内胆管癌及肝门部胆管癌根据MR表现不难作出诊断，胆总管癌须认真分析MR及MRCP表现，鉴别其他低位梗阻性胆道疾病后作出诊断。

MR imaging of cholangiocarcinoma(a report of 32 cases)

Objective:To investigate MR findings and differential diagnosisof cholangiocarcinoma.Methods:MR findings of 32 cases of cholangiocarcinoma proved surgically and pathologically were analyzed retrospectively.Rusults:①The characteristic appearance of intrahepatic cholangiocarcinoma(n=2 ) was a large mass with an irregular margin,satellite nodules,and a central scar.Tumor was hypointense on T1WI and hyperintense on T2WI, and characteristically showed mild or moderate rim enhancement on enhanced MRI.②The MR findings of hilar cholangiocarcinoma (n=18) included intrahepatic biliary dilatation,narrowing or filling defect of left or right duct or common hepatc duct, and soft tissue mass at hilum of liver.③The MR findings of extrahepatic cholangiocarcinoma (n=12) appeared as dilatation of intrahepatic bile duct and the segment of CBD above the lesion, and narrowing,interruption of the segment of CBD invaded by the tumor and soft tissue mass around CBD. Of those imaging findings the position and shape of dilatation,narrowing or filling defect were visualized clearly on MRCP.Conclusion:It is not difficult to make a diagnosis of intrahepatic and hilar cholangiocarcinoma based on MR findings,but CBD carcinoma should be differentiated from other obstructive diseases at lower segment of CBD.