医学影像-胆囊增厚性病变CT诊断.pptVIP

Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 4胆囊腺肌增生症 大小多在10mm以内。 为黏膜上皮增生，罗－阿氏窦扩大、增生并穿入肌层，窦内并发炎症、结石等。 分型：弥漫型、节段型、局限型、混合型 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 病理特点 包括: ( 1)胆囊黏膜上皮和腺体不同程度增生; ( 2) 增生黏膜或腺体陷入肌层甚至深达浆膜下形成许多细小窦状结构, 即RAS, 位置较深或窦口狭窄的RAS易造成胆汁淤积、胆固醇结晶或小结石形成; ( 3) RAS周围绕以数量不等的增生平滑肌组织, 肌层明显增厚、结构紊乱或被增生的腺体分隔。 MR示胆囊壁周围成群点状高信号影（罗-阿氏窦），T2W1上显示最清楚，所以目前MR诊断准确性最高 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 胆囊腺肌增生症 胆囊壁弥漫或局限性增厚，内外壁光整，肝胆分界清楚。 增强：动脉期病变区的黏膜及部分黏膜下明显强化，在门脉期及延迟期，强化沿黏膜面向浆膜面扩展，全层均匀或不均匀显著强化。 增厚胆囊壁内大小不等无强化的RAS及壁内微小结石, 为胆囊腺肌增生症的特征性CT征象。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 弥漫型 胆囊壁不均匀增厚，随时间延长强化逐渐明显，并向浆膜面扩张；囊壁内可见多发扩大的RAS边缘环状强化，MPR显示RAS与囊腔相通 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 节段型 胆囊体底部囊壁呈条索状增厚，胆囊腔闭塞，增强后明显强化，随时间延迟逐渐均匀且更明显。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 胆囊增厚性病变CT诊断 福建医科大学附属第一医院影像科 俞元临 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd. 胆道系统的正常解剖 胆囊分底.体.颈 是储存和浓缩胆汁 胆囊壁厚2mm 其内容物CT值 -5Hu至15Hu 进餐或脂肪餐后 胆囊壁可均匀增厚 Eval