黄色肉芽肿性胆囊炎的CT表现

目的探讨CT对黄色肉芽肿性胆囊炎的诊断价值。方法回顾性分析4例经手术病理证实的黄色肉芽肿性胆囊炎的CT表现，分析其影像学特点。结果术前1例确诊，3例误诊。3例胆囊有不同程度的增大，4例胆囊壁均有增厚，壁厚在4—30mm之间，内均可见形态不规则的低密度灶。2例黏膜线完整，其中1例胆囊颈结石嵌顿，1例胆总管结石，1例胆囊内积气合并肝脏浸润。增强后动脉期的“夹心饼干征”2例，环形强化1例。结论增强后动脉期的“夹心饼干征”和环形强化，对黄色肉芽肿性胆囊炎的诊断有重要价值。

CT features of xanthogranulomatous cholecystitis

Objective To investigate the diagnostic values of CT in xanthogranulomatous cholecystitis (XGC).Methods Retrospective analysis was performed in 4 patients with pathology confirmed XGC. Abdomen CT scans with and without contrast enhancement were performed in all patients. Results Only 1 case was correctly diagnosed before surgery. CT findings included gallbladder enlargement (3 patients), gallbladder wall thickening ( 4 patients), gallstone (1 patient), and common bile duct stone (1 patient). The maximum wall thickness was between 4 mm and 30 mm, with irregular low-density layer inside. Mucosal line was normal in 2 and pericholecystic infiltration in 1. After contrast administration, hypodense band sign was revealed in 2 and rim enhancement sign around the nodules was shown in 1 at arterial phase. Conclusion CT features of hypodense band sign and rim enhancement sign around the nodules in the arterial phase of contrast enhanced CT are strongly suggestive of XGC.