肝内胆管细胞癌的超声诊断

目的:探讨肝内胆管细胞癌的超声声像图特点与诊断。方法:回顾总结85例经手术和(或)穿刺病理证实的肝内胆管细胞癌的超声声像图表现。其中彩超检查64例。结果:病灶直径11～130mm,单发69例(81.2%)。病灶呈不均匀低回声者占72.4%;形态不规则,边界不清青占85.2%;病灶内测及动脉血流45例(70.3%),其中阻力指数大于0.6者40例(88.9%)。定位诊断正确83例(97.6%),漏诊2例。诊断恶性肿瘤65例(76.5%):其中正确提示肝内胆管细胞癌仅11例。疑似恶性肿瘤12例(14.1%)。不能定性及误诊各3例。结论:典型肝内胆管细胞癌的超声声像图表现为形态不规则、边界不清的低回声不均质肿块,病灶内多能测及高阻动脉血流。多种影像学诊断方法结合有助于该病的诊断。

Ultrasographic Diagnosis of Intrahepatic Cholangiocarcinoma

Objective::To investigate the ultrasonography(US)characteristics of intrahepatic cholangio-carcinoma(IHCC). Methods:US findings of IHCC in 85 patients were reviewed retrospectively.All cases were confirmed by surgery or histological biopsy.Sixty-four cases of IHCC were examined with color Doppler US.Results:The tumor size was from 11 mm to 130 mm in diameter and 69(81.2%)cases had single lesion.There were 72.4% lesions showed heterogeneous hypoechogenic,and 85.2% lesions were irregular or blur margin.There were arterial flow signals in 45(70.3%)eases and resistance index(RI)in 40 cases(88.9%)was higher than 0.60.Sixty-five(76.5%)cases were diagnosed as malignant tumors.Only 11 cases were correctly diagnosed as IHCC and 12(14.1%)cases were suspected as malignancies,and other 6 cases were inconclusive or misdiagnosis.Conclusion:Typical US features of IHCC were heterogeneous hypoechoic mass with irregular shape and blur mar- gin.Intratumoralarterial flow signal with high RI were frequently detected in IHCC.Combination of US and other imaging modalities is helpful in the diagnosis of IHCC.