肝内胆管囊腺瘤的CT诊断

目的描述肝内胆管囊腺瘤的CT表现,探讨该肿瘤的CT征象。方法回顾性分析经手术病理证实的6例肝内胆管囊腺瘤的CT表现和诊断。结果 6例肿瘤最大径为5.4～26.4cm,平均11.2cm。3例位于肝右叶,2例位于肝左叶,1例同时累及肝左右叶。肿瘤均为多房性单发囊性肿块,内见多发分隔,边界清楚。2例囊内分隔局部增厚,其中1例见分隔处有局限性乳头状突起,1例见壁结节,1例分隔见多个点状及短线状钙化。增强后,囊壁、分隔、乳头状突起及壁结节轻至中度强化。2例因肿块压迫出现肝内胆管扩张。其中1例肿块的小囊与肝内扩张的胆管相通。结论中年女性,CT表现为肝内单发低密度囊性肿块,边界清楚,囊内有多个分隔,囊内可有乳头状突起或壁结节,此时应考虑肝内胆管囊腺瘤的诊断。

CT findings of intrahepatic biliary cystadenoma

Objective To describe the CT manifestations of the intrahepatic biliary cystadenoma and to explore the CT diagnostic value. Methods The CT features of six cases of pathologically proven intrahepatic biliary cystadenoma were retrospectively analyzed. Results The largest diameter of these tumors ranged from 5.4 to 26.4 cm, with a mean of 11.2 cm. Three cases were in the right hepatic lobe, two were in the left lobe, and one in both lobes. All of the tumors were solitary multilocular cystic masses with well-defined margins. Focal thickening of internal septa was found in two cases. Localized papillary mural nodules （1） and punctuate （1） and linear （1） calcifications were also seen. There was slight to moderate contrast enhancement of the capsules, internal septa, papillary projections and mural nodules. Intrahepatic cholangiectasis resulted from bile duct compression in two cases. The tumor communicated with the dilated intrahepatic bile ducts in one patient. Conclusion Characteristic CT features of intrahepatie biliary cystadenoma are solitary hypodense cystic masses with regular borders, multiple septa, papillary projections and mural nodules. When these CT characteristics are found in the middle-aged female, diagnosis of intrahepatic biliary cystadenoma should be considered.