胆囊腺肌增生症的多排螺旋CT的诊断特点

目的探讨胆囊腺肌增生症的CT表现特点,提高对其诊断的准确性。方法收集2005年1月至2007年12月经CT诊断并经手术和病理证实的13例胆囊腺肌增生症患者。采用16层螺旋CT作平扫及多时相增强扫描,胆囊区作2.0mm薄层重建,显示囊壁情况。结果13例中有2例在强化灶中可见小囊状低密影,即Rokitan-sky-Aschoff窦。依据病理,结合CT表现可分3型:①弥漫型5例;②节段型1例;③局限型7例。弥漫型及节段型CT表现:平扫胆囊壁呈明显增厚的软组织影,增强后出现"环样"强化灶。局限型表现为胆囊体部或底部呈局部增厚的软组织影,增强后出现"舌样"强化灶。结论采用多排螺旋CT多时相扫描后薄层重建,能较好地显示"二环征"、"三环征"及"舌样"强化征,这是CT诊断胆囊腺肌增生症的重要依据。

The exploring of spiral CT for the diagnosis of adenomyomatosis of the gallbladder

Objective To explore the characteristic of CT imaging in adenomyomatosis of the gallbladder and improve the diagnostic knowledge of this disease. Methods Thirteen patients with adenomyomatosis of the gallbladder from January in 2005 to December in 2007. The 13 patients were diagnosed by CT examination including plain, dynamic or muhiphase enhancement and were all proved surgically and pathologically. The gallbladder wall was performed by 16 spiral CT examination including plain or muhiphase enhancement, 2 mm thin-slice reconstitution in the involved area and the magnification of imaging was involved sometimes. Results According to its pathologic change and CT findings ,it maybe divided into three types： （1） diffuse type 5 cases; （2） segmental type 1 case; （3） localized type 7 cases. CT findings in the diffuse and segmental types included segmental or diffuse gallbladder wall thickening and enhancement of wall layer, which were presented as the characteristic ＂aureola＂ sign during triphase contrast CT scanning. Localized gallbladder wall thickening and ＂tongue＂ sign resulted from the enhancement of wall layer were also clearly shown in the localized type. Conclusion Uses muhi-platoon screw CT many after when scans the thin layer reconstruction, can the good demonstration ＂two links draft＂, ＂three links drafts＂ and ＂the tongue type＂ the strengthening drafts, this is this gets sick the CT diagnosis important basis.