原发性胆管癌的螺旋CT诊断分析

目的分析原发性胆管癌的螺旋CT表现特征。方法回顾性分析经手术病理证实的87例胆管癌的螺旋CT平扫及动态增强表现特征。结果肝内周围型胆管癌（19例）平扫呈相对低密度或等密度肿块，增强扫描肝动脉期17例呈边缘环状强化，2例无强化，门静脉期12例呈中心强化，延迟期中心强化更明显，坏死区无强化；48例肝门区胆管癌中42例呈浸润性肿块，增强早期呈轻至中度强化，晚期强化明显，少数无强化；肝外胆管癌（20例）多呈浸润性生长或表现为腔内乳头状肿块，增强早期呈中度强化，晚期明显强化。结论螺旋CT多期增强扫描，是诊断原发性胆管癌的重要影像检查方法，能较准确地显示各类胆管癌的生长特征，延迟扫描对胆管癌的诊断和鉴别诊断有重要参考价值。

Helical CT diagnosis of primary cholangiocarcinoma

Objective To analyze the features of helical CT images of in primary cholangiocarcinoma. Methods The features of plain and dynamic enhanced CT in 87 patients with cholangiocarcinoma proved by surgery and pathology were retrospectively analyzed. Results Intrahepatic peripheral cholangiocarcinoma (19 cases) presents as a hypoattenuating or isoattenuating mass relative to the liver parenchyma on unenhanced scans. After contrast material-enhanced, rim-like enhancement (17/19) and central region enhancement (12/19) were the frequent enhancement patterns in early stage and delayed scans, respectively. Two cases showed no enhancement in all the phases. The 42 patients with hilar cholangiocarcinoma showed infiltrative mass. After contrast enhancement, the tumor presented with mild to moderate enhancement during the early phase and the degree of enhanced increased distinctly during delayed phase. Extrahepatic cholangiocarcinoma often showed infiltration or intraluminal mass. During the portal venous phase (PVP), the tumor's attenuation increased incoordinately. During the delayed phase, the tumors attenuation showed an uptrend. Conclusions Dynamic contrast enhancement scan of helical CT is the important imaging means for the diagnosis of primary cholangiocarcinoma for it can show the growth patterns of various cholangiocarcinoma exactly. The delayed-phase scan has important value in the diagnosis and differential diagnosis of cholangiocarcinoma.