黄色肉芽肿性胆囊炎的CT表现

目的探讨黄色肉芽肿性胆囊炎(XGC)的CT表现特点,提高对XGC的诊断水平.方法回顾性分析经手术病理证实的29例XGC的CT检查资料.结果术前诊断为胆囊癌15例,慢性结石性胆囊炎14例.29例均有不同程度的胆囊壁增厚,其中局限性胆囊壁增厚8例,弥漫性胆囊壁增厚21例;增厚的胆囊壁内见单发或多发低密度结节15例;伴发胆囊结石26例;肝-胆界面较清楚者24例,肝-胆界面不清者5例;增强后增厚的胆囊壁在动脉期仅有轻度强化,门脉期至延迟期强化逐渐明显,胆囊壁内低密度结节影强化不明显,增强后显示密度较高的黏膜线9例.结论增强后增厚的胆囊壁延迟强化,增厚的胆囊壁内低密度结节,胆囊轮廓及黏膜线的存在对本病诊断有意义.

CT characteristics of xanthogranulomatous cholecystitis

Objective To investigate the CT characteristics of xanthogranulomatous cholecystitis (XGC) and improve the CT diagnostic accuracy of the disease. Methods Twenty-nine cases of XGC proved by operation and pathology were retrospectively analyzed. Results Fifteen cases were diagnosed as gallbladder carcinoma and 14 cases as cholecystitis before operation. The gallbladder walls were thickened in all cases, focally in 8 and diffusely in 21; single or multiple hypodense nodules in the thickened walls were presented in 15 cases; stones were found in 26 gallbladder; the interface between the gallbladder and the liver was clear in 24 cases, unclear in 5 cases; the contrast enhancement of the thickened wall was mild in arterial phase and then obvious in late phase in 29 cases, all hypodense nodules in the thickened walls had no enhancement, mucosal line was observed in 9 cases. Conclusion The enhancement of thickened wall was mild in arterial phase and then obvious in late phase when contrast material was administered, the presence of hypodense nodule(s) in the thickened walls and mucosal line, is highly suggestive of the disease.