Mirizzi's综合征的CT表现

本文总结分析了16例Mirizzi's综合征的临床资料和CT图象,16例病人的CT表现包括:(1)胰腺段以上的肝外胆管扩张,(2)胆囊萎缩、扩大或正常大小;(3)胆囊壁增厚;(4)胆囊周围炎性表现;(5)肝门区多囊多管征,肝门区各结构间脂间隙模糊、消失,肝外胆管壁增厚;(6)肝门区含钙结石位于囊、管结构内或位于其外;(7)可伴有肝硬化。上述征象中,肝门区多囊多管征、肝门区脂间隙改变及肝外胆管壁增厚,文献中未曾报道。本文病例的CT表现与手术结果相符合,这些征象是由于胆囊管的扩张、扭曲,以及胆囊周围炎累及肝门和肝外胆管造成的。在梗阻性黄疸的CT鉴别诊断中,当出现上述征象,特别是肝门区多囊多管征象,要考虑此综合征的可能。

A CT Study on 16 Cases of Mirizzi's Syndrome

The CT features and clinical data of 16 cases of Mirizzi's syndrome were reviewed, and the followiong CT features were demonstrated: (1) Dilatation of the suprapancreatic segment of the common bile duct and intrahepatic ducts. (2)Atrophy, dilatation or normal size of the gallbladder. (3)Thickening of the gallbladder wall. (4)Inflammatory reactions in the pericystic areas. (5) Either intracystically or extracystically located calcified stones in the porta hepatis. (6) Liver cirrhosis might occur. (7) An increase of the number of the cystic or tubular structures in the porta hepatis,blurring of the fat space in the porta hepatis, thickenning of bile duct wall. The last CT feature of Mirizzi's syndrome has never been reported in the literature. The surgical findings were consistent with the CT features in these patients the CT feature we reported may be caused by obstruction and inflammation of cystic tubule. It is suggested that in the differential diagnosis of obstructive jaundice, Mirizzi's syndrome should be considered whenever multiple cystic or tubular structures are found in the porta hepatis.