厚壁型胆囊癌与慢性胆囊炎CT鉴别诊断

目的：着重探讨CT对厚壁型胆囊癌与慢性胆囊炎的鉴别诊断价值。材料和方法：回顾性分析15例厚壁型胆囊癌和30例慢性胆囊炎的CT表现特征，并作鉴别诊断。结果：①厚壁型胆囊癌15例中，CT显示为胆囊肿大且壁不均增厚9例（33．3％），胆囊壁僵硬且边界不清8例（53．3％），胆囊壁连续性中断5例（33．3％），胆囊壁均匀强化13例（86．0％），肝门淋巴结肿大5例（33．3％），②慢性胆囊炎30例中，CT显示胆囊壁均匀增厚5例（16．7％），胆囊边缘模糊不清25例（83．3％），胆囊壁轻度强化30例（100．0％），胆囊周围积液、积气4例（13．0％），胆囊炎合并结石9例（30．0％）。结论：螺旋CT双期增强扫描在显示厚壁型胆囊癌与慢性胆囊炎CT表现特征及其鉴别诊断上，具有重要价值。

A Thickened-wall Gallbladder Carcinoma and Chronic Cholecystitis:Differentiation in CT

Objective:To study of differential diagnoses value of thickened-wall gallbladder carcinoma and chronic cholecystitis from CT.Methods:CT features and the differential diagnoses of 15 patients with thickened-wall gallbladder Carcinoma,and 30 patients with chronic cholecystitis by clinical and scanming were analysed,retspectively.Results:(1)Among 15 patients of thickened-wall gallbladder carcinoma,enlargement and thickened of gallbladder in 9 cases(60.0%);incomplete and severely thickened invasive mass in 8 cases(53.3%);wall irregularity and destructive gallbladder carcinoma in 5 cases(33.3%);enlargement of hilar lympha nodes in 5 cases(33.3%)and marked inhomogeneous enhacement of invasive mass in 13 cases(86.0%).(2)Among 30 cases with chronic cholecystitis,the gallbladder-wall was mildly thickened in 5 cases(16.7%),slightly enhancement gallbladder-wall in 30 cases(100.0%),peripheral fluid and air collection in 4 cases(13.0%);intrahepatic focal enhacement in 5 cases(16.7%)and intracystic stones in 9 cases(30.0%).Conclusion:Assessment of MCT findings might be helpful in distinguishing the gallbladder cancinoma from chronic cholecystitys.