肝内周围型胆管细胞癌的CT表现

目的研究肝内周围型胆管细胞痛（IHPCC）的CT表现。方法17例经手术病理证实的IHPCC患者均经常规CT平扫和三期动态增强扫描。对所有患者的CT表现进行了回顾性分析。结果17例IHPCC患者中，肝脏左叶和右叶的病变分别见于13和4例；单发与多发病灶分别见于16和1例，圆形与分叶状病灶分别见于8和9例。病变直径2．1～11cm之间。在CT平扫像上，病变密度低于肝实质，CT值介于10—30HU。IHPCC伴胆管扩张和结石分别见于8和1例。病变区肝脏轮廓显示膨隆7例，外部轮廓萎陷6例。在动态增强CT像上，病灶边缘呈连续或不连续的薄环形强化，病灶内部呈线条状或网状强化。在延迟期CT像上，病灶内部不均匀强化较动脉期明显。结论IHPCC在CT平扫与动态增强CT像上具有特征性表现，尤其肝内发现边缘强化的低密度病灶伴胆管扩张，以及延迟期像上显著强化，高度提示本病。

CT findings of intrahepatic peripheral eholangioearcinama

Objective To study the CT findings of intrahepatie peripheral cholangiocarcinam （IHPCC）. Methods Seventeen patients with surgically and pathologically proved IHPCC underwent unenhanced and triphasic dynamic enhanced CT scans of the abdomen. The CT findings of all patients were analyzed retrospectively. Results Among 17 patients with IHPCC, the lesions situated in liver left and right lobe were 13 and 4 cases, respectively; single and multiple lesions were 16 and 1 case, respectively; round and lobulated lesions were 8 and 9 cases, respectively. The lesion diameter ranged frmn 2.1 cm to 11.0 cm. On unenhanced CT images, the lesion density was lower than hepatic parenchyma; the lesion CT value ranged from 10 HU to 30 HU; 1HPCC associated with biliary dilatations and calculi were found in 8 anti 1 case, respectively, the liver outline expansion and collaps of the involved areas were found in 7 and 6 cases, respectively. On dynamic enhanced CT images, the lesion margin appeared as continued or non-continued thin circular enhancement, while the lesion inside appeared as linear or reticular enhancement. On delayed images, non-homogeneous enhancement of the lesion inside was more significant than that of arterial phase. Conclusion IHPCC has characteristic findings on unenhanced and enhanced CT images, especially detection of a hypodense hepatic lesion with peripheral enhancement, biliary dilatation, and significant enhancement on delayed images are highly suggestive of IHPCC.