周围型肝内胆管细胞癌的CT影像学分析

目的：分析21例经病理证实的周围型肝内胆管细胞癌的CT影像学表现,并复习相关文献帮助了解其表现机制及诊断。方法：回顾性分析21例经病理证实的周围型肝内胆管细胞癌的CT表现。结果：21例患者均属单发低密度病灶;部位：肝左叶12例（57%）,肝右叶8例（38%）,同时侵犯肝左右叶1例（4.8%）;大小：2.5~6.8cm;密度：密度均为低密度且基本均匀,其中6例病灶中央有更低密度区,CT值均小于50HU;边缘：呈不规则分叶状14例（67%）,边缘较清楚,类圆形或圆形7例（33%）,与正常肝实质分界不清;其他征象：肝内胆管扩张者11例（52%）,肝包膜内陷回缩3例（14%）,肝内结石5例（24%）,腹膜后及肝门部淋巴结肿大者5例（24%）;增强扫描表现：病灶呈轻到中度强化,呈＂慢进慢出＂特点。结论：64层螺旋CT对周围型肝内胆管细胞癌有很好的诊断价值。

CT imaging analysis of intrahepatic peripheral cholangiocarcinam

Objective：To analyze 21 cases of CT imaging findings of pathologically confirmed intrahepatic peripheral cholangiocarcinam（IHPCC） and review the relevant literatures to help understand the mechanism of its realization and the diagnosis.Methods：A retrospective analysis was made of CT imaging of 21 cases of IHPCC.Results：Each focus was the single low-density lesion in 21 cases.Position：13 cases（62%） were in the left lobe of the liver,8 cases（38%）were in the right lobe of the liver,and only one focus was at the junction of two lobes of the liver.Size：the lesion diameter ranged from 2.5 cm to 6.8 cm.Density：the density was lower in 21 cases of IHPCC than that in hepatic parenchyma,of which 6 cases had more low-density lesions in the central area.CT value was less than 50HU.Edge：the edge was more clear and irregular lobulation in 14 cases（67%） and round or class round in 7 cases（33%） with unclear boundaries.Other Signs：11 cases（52%） showed intrahepatic bile duct dilatation,3 cases（14%） hepatic capsular retraction,5 cases（24%） intrahepatic stones and 5 cases（24%）retroperitoneal and hilarlymph node enlargement.Enhanced Scanning：lesions showed mild to moderate enhancement,with a feature of ＂slowly coming into and slowly going out＂.Conclusion：64-spiring CT has a high value in diagnosing intrahepatic peripheral cholangiocarcinam.