胆囊癌的CT诊断

目的探讨胆囊癌的CT表现与诊断价值.材料和方法104例经手术和病理证实的胆囊癌病人(术前诊断89例,术后复查15例),回顾复习其手术前后的影像学表现和分析漏、误诊因素.另有78例病人作了术后临床随访.结果CT对胆囊癌诊断正确率为85.2%,漏诊率为14.8%,经腹超声则分别为59.3%和40.7%(两者P值均＜0.001).CT图像显示胆囊癌的特征性表现有胆囊壁局限性或弥漫性不规则增厚46例次;腔内乳头状或结节状影20例次;胆囊肿块18例次.15例胆囊癌术后1年内复查,14例出现多处转移.78例临床随访者中,存活5年以上者8例(10.26%).结论胆囊癌病人的预后不甚理想.CT对其诊断正确率较高,但早期发现仍存在一定困难.

CT Diagnosis of Gallbladder Carcinoma

Purpose: To explore and evaluate the CT diagnosis and the value of gallbladder carcinoma. Materials and Methods: CT findings of 104 cases with gallbladder carcinoma(89 pre - operative and 15 after - operative) proved by surgery or pathology were retrospectively reviewed and the effects of misdiagnosis were analyzed. Another group of 78 after - operative cases were follow - up clinically. Results: Compared with ul-trasonography.CT diagnosis was accurate(85.2%) and missing(14.8%),while US was 59.3% and 40.7% (P<0.001).CT features of gallbladder carcinoma included local or diffuse thickened cystic wall;papillary or nodular shadows within cystic cavity and cystic mass. 15 cases operated were examined with CT or EUS within the duration of 1 year,multiple metastases were discovered in 14 cases.Only 8 cases were survival over 5 years(10.26%) in 78 clinical follow - up cases. Conclusion: The prognosis of primary gallbladder carcinoma was not so good. Although the accuracy of CT diagnosis was higher,but the early diagnosis was still difficult.