复旦医学影像学-消化系统课件.ppt

Cholangiocarcinoma arise from the epithelium of bile ducts and are usually adenocarcinomas Growth patterns include mass forming, periductal infiltrating, and intraductal polypoid Mass forming periductal infiltrating Intraductal polypoid Peripheral cholangiocarcinoma Delayed enhancement biliary dilatation Atrophy (liver) Perihilar and extrahepatic cholangiocarcinomas typically exhibit an infiltrating growth pattern focal, circumferential thickening of the bile duct with proximal dilatation perihilar lesions may be similar in appearance to the intrahepatic, mass-forming type of cholangiocarcinoma, or may manifest as an intraluminal polypoid mass Pancreatic carcinoma a highly lethal tumor CT is recommended for initial imaging assessment CT:a hypodense mass that distorts the contour of the gland obstruction of the common bile duct and pancreatic duct and atrophy of pancreatic tissue beyond the tumor A B C D Signs of unresectability tumor involvement of adjacent organs enlarged regional lymph nodes (15 mm) encasement or obstruction of peripancreatic arteries or veins metastases in the liver peritoneal carcinomatosis Pancreatic Carcinoma: Nonresectable encases and narrows the celiac axis and its branches partially envelopes the aorta Plain film radiographs of the abdomen are important for the assessment of the acute abdomen CT, US, and MR provide comprehensive evaluation of the abdomen, including the peritoneal cavity, retroperitoneal compartments, abdominal and pelvic organs, blood vessels, and lymph nodes Thank you ! Email:rao.shengxiang@ The attenuation value of the liver parenchyma is markedly lower than that of the spleen The intrahepatic vessels stand out as hyperattenuating structures Focal fatty infiltration The same imaging features as diffuse infiltration Vessels run their normal course through the area of involvement (lack of mass effect ) Cirrhosis hypertrophy of the caudate lobe and left lobe with shrinkage of the right lobe inhomogeneity of