肝内周围型胆管细胞癌的CT影像分析

目的回顾分析经病理证实的肝内周围型胆管细胞癌的CT影像表现,以提高术前诊断准确率。方法本组17例病例采用PQ-2000S单排螺旋CT平扫及三期增强扫描。结果CT平扫显示肿块呈不规则形态（13例）或类圆形（4例）,58.8%患者病灶呈低或稍低密度。增强扫描动脉期病灶无明显强化或边缘轻-中度强化,门静脉期及延迟扫描病灶强化逐渐明显,部分病例有逐渐填充趋势;肿块多合并肝内胆管扩张、肝门淋巴结肿大、附近肝叶萎缩等间接征象。结论肝内周围型胆管细胞癌CT扫描有较特征性影像表现,结合AFP等检查可与肝细胞癌和肝血管瘤等肝内其他占位病变相鉴别。

CT Imaging Analysis of Peripheral Cholangiocarcinoma

Objective This study aims to improve the accuracy of diagnosis of peripheral cholangiocarcinoma by CT scan. Methods Results of plain and enhancement CT scan using PQ-2000S CT scanner from seventeen cases, including 11 males and 6 females, of peripheral intrahepatic cholangiocarcinoma proven by surgery or biopsy were retrospectively analyzed and examined. Results Lesion images from 13 patients showed irregular shape and rounded or ovoid in another 4 cases. 58.8% of patients had low attentuation lesions. The lesions were not clear or light-middle enhancement on the arterial phase, but gradually enhanced and obvious on the portal phase. Hepatic lobe atrophy was found in 6 patients, intrahepatic cholangiectasis in 12 cases and metastasis of lymph nodes in 8 cases. Conclusion Combined with AFP detection, CT scan can distinguish peripheral cholangiocarcinoma from hepatocellular carcinoma and hemangioma in liver.