胆囊癌的CT单相扫描与多相扫描的比较研究

目的 比较胆囊癌CT单相扫描与多相扫描的不同诊断价值。方法 对36例经手术病理证实的胆囊癌病人行CT检查，其中11例单相扫描（平扫＋普通增强扫描＋延迟扫描）；25例行多相扫描（平扫＋动脉相＋门脉相＋延迟扫描）。结果 根据CT表现，胆囊癌可分为3型：第1型为胆囊腔内肿块型；第2型为胆囊壁增厚型；第3型为浸润性生长型。胆囊癌以中度－明显强化多见，且门脉相强化明显，持续至延尺相，不同类型胆囊癌强化形式不同。胆囊癌伴肝脏侵犯常见，此时，强化形式与胆囊癌类似，与原发性肝癌不同；胆囊癌的其他表现尚有结石，淋巴结肿大及胆道梗阻等。结论 胆囊癌病人行CT多相扫描，可以明显胆囊癌的特征表现，有助于胆囊癌的正确诊断。CT对胆囊癌的定位及分期很有价值。

CT diagnosis of the gallbladder carcinoma: comparison of single-phase scan and multi-phase scan

Objective To compare CT diagnosis of the gallbladder carcinoma with single phase and multi phase scan. Methods Thirty six patients with histologically proven carcinoma of the gallbladder were examined by Compu ted Tomography (CT), eleven of them were examined by single phase CT scan (plain, enhanced and delayed scan); 25 of them were examined by multi phase CT scan (plain arterial venous delayed scan). CT images were compared with operation fingdings. Results According to CT findings, the gallbladder carcinoma was categorized into three types: Type 1, intraluminal mass of the gallbladder; Type 2, thickening of the gallbladder wall; Type 3, infiltrating tumor. The majority of gallbladder carcinoma was medium or obvious enhancing, especially in venous scan, and lasted to delay scan. Different types had various enhancenments. Liver involvement was the most common associated findings. In this situation, the enhancement of the involved liver was the same as the gallbladder carcinoma, was different from the enhancement to the primary hepatic cancer. Other ancillary features included presence of calculi, lymphadenopathy and biliary obstruction, etc. Conclusion Multi phase CT scan can identify the features of the gallbladder carcinoma and is helpful for the correct diagnosis. CT is found useful for characterizing and defining the extent of carcinoma of the gallbladder. CT can also be used for biopsy guidance to the gallbladder mass.