不同生长方式肝内胆管细胞癌的CT表现

目的探讨不同生长方式肝内胆管细胞癌CT表现。方法回顾性分析34例经手术、活检或临床随访证实的肝内胆管细胞癌动态CT表现。结果34例肝内胆管细胞癌中,肿块形成型27例,围管浸润型5例,腔内生长型2例。肿块形成型CT平扫表现为低密度肿块24例,3例表现为等或高密度肿块;增强动脉期周边轻度强化,门脉期强化程度有增加,延迟期16例表现为均匀强化,11例表现为肿块周边不均匀强化,中央始终无强化。围管浸润型表现为胆管壁的不规整增厚2例,闭塞3例。2例腔内生长型表现为扩张胆管内强化结节。结论肝内胆管细胞癌生长方式的不同,有不同的CT表现。熟悉不同生长方式的肝内胆管细胞癌的动态CT表现,有利于诊断与治疗方案的选择和预后的判断。

CT Manifestations of Intrahepatic Cholangiocarcinoma with Different Growth Pattern

Objective To investigate CT features of intrahepatic cholangiocarcinoma with different growth pattern.MethodsDynamic CT manifestations of intrahepatic cholangiocarcinoma proved by surgery,biopsy and clinical following in 34 cases were analyzedretrospectively.Results There were 27 cases of mass-forming type,5 cases of periductuctal-infiltrating type and 2 cases of intraductal-growing type.Of the 27 cases of mass-forming type,24 cases appeared as hypoattenuation masses,while 3 cases appeared as isoattenuation or hyperattenuation masses.Rimlike enhancement around the periphery of the tumor on arterial phase and gradual centripetal enhancement on portal vein phase were observed after contrast administration.On delayed phase images,the mass enhancement were homogeneous in 16 cases,while the remained 11 cases showed irregular periphery enhancement with the central partial without any enhancement.Periductal-infiltrating cholangiocarcinoma manifested as diffusely narrow with irregular thickened ductal wall in 2 case,and bile duct obliterated in the other 3 cases.2 cases of intraductal-growing cholangiocarcinoma appeared as enhanced node in the dilated bile duct.Conclusion Intrahepatic cholangiocarcinomas with different growth pattern have different CT manifestations.It is helpful for diagnosing,choosing the appropriate treatment and predicting prognosis to familiar with their dynamic CT manifestations.