黄色肉芽肿性胆囊炎的MRI表现特点

目的：探讨黄色肉芽肿性胆囊炎（Xanthogranulomatous cholecystitis，XGC）的MRI影像表现特点。方法：回顾性分析15例经病理证实为XGC的患者的术前MRI影像。观察胆囊本身改变（壁增厚的方式和程度、信号特点、黏膜线是否完整、强化程度及是否有结石）、胆囊周围脂肪及肝实质的改变。结果：15例患者均出现胆囊壁增厚，范围为0.8~2.6cm，其中13例为弥漫性增厚，2例为局灶性增厚。13例弥漫性增厚的病例中均匀性增厚2例，不均匀增厚11例。10例患者出现胆囊壁内结节，大小为0.2~0.7cm，表现为较长T1、长T2信号，增强扫描未见确切强化。15例患者均表现为黏膜线显著强化，其中黏膜线完整11例，中断4例。合并胆囊结石15例。所有病例均出现肝实质动脉期一过性强化，邻近肝实质出现肝脓肿7例，与十二指肠粘连6例。结论：胆囊壁不均匀增厚、壁内出现结节、黏膜线完整并明显强化、邻近肝实质动脉期一过性强化是XGC较常见的影像表现，并符合其病理特点。

MRI imaging features of xanthogranulomatous cholecystitis

Objective：To investigate MRI features of xanthogranulomatous cholecystitis（XGC）.Methods：A retrospective analysis was performed on 15 patients with histological confirmed XGC.All patients underwent preoperative MRI scanning.The MRI features were： the presence of intramural nodules,mucosal line,the patterns of wall thickening and enhancement,and the presence of stones in the gallbladder.Peribiliary fat tissue and liver parenchyma changes were also reviewed.MRI features were correlated with pathologic findings.Results：Gallbladder wall thickening occurred in all of the 15 cases.The thickness of gallbladder wall was differ from 0.8cm to 2.6cm,in which 2 cases were local thickening,13 cases were diffuse thickening;2 cases were homogeneous thickening,and 11 cases had inhomogeneous thickening.Nodules were found in 10 patients,which were low signal intensity on T1WI and high signal intensity T2WI.Mucous membrane enhanced significantly in all cases,in which 11 cases had intact mucosal lining,4 cases had interrupted mucosal lining.All patients had cholecystolithiasis.Temporal enhancement of arterial phase in liver parenchyma in all case.Seven cases associated with liver abscess.Six cases had duodenal adhesions.Conclusion：Frequent image manifestations of XGC were asymmetrical thickening of gallbladder wall,nodule in gallbladder wall,intact mucosal lining,and temporal enhancement of arterial phase in liver parenchyma.All of these features were relevant to pathological results.